Morphology rv gives rise to a great vessel that archesao. The hallmark of transposition of the great arteries is ventriculoarterial discordance, in which the aorta arises from the morphologic right ventricle and the pulmonary artery arises from the morphologic left ventricle. Transposition of great arteries in transposition of the great arteries, the two major arteries leaving the heart are connected to the wrong ventricles, the two lower chambers of the heart. Transposition of the great arteries data wisconsin. Complete transposition of the great arteries is also known as dtga. Comparison of late results of arterial switch versus atrial switch mustard procedure operation for transposition of the great arteries all marcs picu cardiology foam can be found on picu doctor and can be downloaded as a handy app for free on iphone or android. The two upper ones are called the right atrium and left atrium. So the two great arteries that come out of the heart are the pulmonary artery, which leads. Congenitally corrected transposition of the great arteries. Pdf the transposition of the great arteries tga is a complex congenital heart disease.
The two major arteries that carry blood away from the heart the aorta and the pulmonary artery. Transposition of the great arteries and intact ventricular septum. Transposition of the great arteries genetic and rare. The aorta and pulmonary artery are reversed, which causes oxygenpoor blood to be circulated to the body and oxygenrich blood to be circulated between the lungs and the heart, rather than to the body. The small coronary arteries, which feed the heart muscle with blood, need to be transferred as well as the two great arteries aorta and pulmonary artery. An image on an egg on a string is superimposed on this chest radiograph to clairfy the appearance of the egg on a string sign of transposition of the great arteries, with enlargement of the cardiac silhouette and atrophy of the thymus leading to narrowing of the upper mediastinum. Transposition of the great arteries tga is a heart condition that is present at birth and is often called a congenital heart defect. Transposition of the great arteries cs mott childrens. Corrected transposition of the great arteries 359 anatomical characteristics and associated lesions notably, in most cases, the interventicular septum has a sagittal orientation with the ventricles at both sides in hearts that tend to mesocardia within the thorax fig.
Transposition of the great arteries tga arterial switch operation aso jatene operation. In transposition of the great arteries, the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle the exact opposite of a normal hearts anatomy. It is one of the most common cyanotic heart diseases, and most affected neonates are undiagnosed as fetuses. Tga might also be referred to as transposition of the great vessels, but tga is the more common term. Hie multimedia transposition of the great arteries. Transposition of the great arteries tga is the most common cyanotic congenital heart lesion that presents in neonates.
Tga causes the diversion of normal blood circulation, robbing the body of oxygen and nutrients. In tga, the two main arteries connected to the heart the aorta and pulmonary artery are switched. Congenital heart disease, transposition of the great arteries, arterial switch operation, atrial switch. Transposition of the great arteries 0 university of chicago. Tga occurs in about 3% of all congenital heart defects. Pdf transposition of the great arteries and coarctation of the. In rare cases, even the chambers of the heart will be swapped. Pediatric cardiothoracic surgery transposition of great. In 50% of cases, the va discordance is an isolated finding.
However, the term transposition was only applied in 1814, by farre, meaning that aorta and pulmonary trunk were placed positio across trans the ventricular. Complete transposition of the great arteries toga occurs when the aorta, which normally comes off the left ventricle and pumps red blood to the body, arises from the right ventricle1 and pumps blue blood returning from the body back to the body bypassing the lungs completely. Transposition of the great arteries tga is a heart defect that occurs from birth congenital. Transposition of the great arteries tga is the most common cyanotic congenital heart disease chd in newborns, with an incidence of 0. Transposition of the great arteries choc childrens. Transposition of the great arteries is usually detected either prenatally or within the first hours to weeks of life. Transposition of the great vessels tgv is a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels. Transposition of great arteries video khan academy. Early estimates from the report of the new england regional infant program reported the incidence of transposition of the great arteries to be 218 per million live births. Morphological lv gives rise to a great vessel that br. Having a baby with transposition of the great arteries can be alarming, but with proper treatment, the outlook is promising.
To understand cctga, it helps to first understand how a normal heart works. Transposition of the great arteries pubmed central pmc. Approximately 5 7% of babies born with congenital present at birth heart defects are born with tga tgv. Transposition of the great arteries tga is a type of congenital heart defect in which there is a reversal of the normal connections of the aorta and the pulmonary artery with the heart. The incidence is estimated at 1 in 3,5005,000 live births, with a maletofemale ratio 1. Transposition of the great arteries tga is a group of congenital defects in which the position of major blood vessels of the heart are switched. Transposition of the great arteries tga the embryo. Transposition of the great arteries childrens hospital. Transposition of the great arteries tga is a congenital heart defect where the aorta and pulmonary artery are switched. Diagnosis of transposition of the great arteries in the fetus. A variety of descriptions have been used to characterize tga, but the most precise portrayal is a chd in which the morphologic right ventricle rv. Pdf clinical guidelines for the management of patients with.
Transposition of the great arteries orphanet journal of. Transposition of the great arteries tga constitutes 5% of all cyanotic congenital heart defects chds and 10% of all neonatal cyanotic chds 1 and is the most common cyanotic chd in the neonate. It is also commonly referred to as congenitally corrected tga, double discordance, or ventricular inversion. Diagnosis of transposition of the great arteries in the. Corrective surgery soon after birth is the usual treatment for transposition of the great arteries. Even when other heart defects are present, they often cannot fully compensate for the switched vessels in order to support life for an extended period of time. Transposition of the great arteries or tga is a potentially fatal congenital heart malformation where the pulmonary artery and the aorta are switched. Levotransposition of the great arteries is an acyanotic congenital heart defect in which the primary arteries the aorta and the pulmonary artery are transposed, with the aorta anterior and to the left of the pulmonary artery. Congenital heart diseases involving only the primary arteries pulmonary artery and aorta belong to a subgroup called transposition of the great arteries. U nderstanding your childs heart transposition of the. Transposition of the great arteries march 23 at 11. Subxiphoid twodimensional echocardiographic identification of tricuspid valve abnormalities in transposition of the great arteries with ventricular septal defect.
The transposition of the great arteries tga is a complex congenital heart. In a normal heart, there are two large arteries that carry blood out of the heart. Unlike the other form of transposition transposition of the great arteries. The transposition of the great arteries was first described by mathew baillie in 1797, in the second edition of the book the morbid anatomy of some of the most important parts of the human body. Living with corrected transposition of the great arteries. Transposition of the great arteries is the second most common congenital heart defect that causes problems in early infancy.
This lesion presents in 57% of all patients with congenital heart disease. Complete transposition of the great arteries tga is a rare congenital heart defect. Transposition is a switching, oneforone switch, a for b, and b going where a is supposed to go. The aorta also tends to be on the right and anterior, and the great arteries are parallel rather than crossing as they do in.
This changes the way blood circulates through the body causing oxygenpoor blood to flow to the body. Transposition of the great arteries tga heart defect. Transposition of the great arteries is the most common form of cyanotic congenital heart disease presenting in the newborn period and comprises approximately 5% of all congenital heart defects. Transposition of great arteries tga radiology case. Transposition of the great arteries, ltype congenital. Multimodality imaging guidelines of patients with transposition of. Levo or llooped transposition of the great arteries ltga is a rare form of congenital heart disease characterized by atrioventricular and ventriculoarterial discordance. It is different from and much less common than regular transposition of the great arteries tga or dtga. Transposition of the great arteries tga is a common congenital cardiac anomaly and accounts for 45% of all congenital heart disease. Transposition of the great arteries tga is a complex congenital heart defect. The sequelae of the complex congenital heart diseases could be severe if undiagnosed before birth. The switch means that the aorta, which normally carries oxygenated blood, carries deoxygenated blood. Dtransposition of the great arteries henceforth referred to simply as transposition or tga represents 57 % of congenital heart disease and is the second most common cyanotic defect after tetralogy of fallot 1. Revival and modification of the mustard operation the journal of.
The result is that blood containing oxygen from the lungs is pumped back into the lungs, while blood that lacks oxygen, which is necessary to nourish the. Transposition of the great arteries symptoms and causes. In the majority of patients with tga, the aorta is rightward and anterior to the pulmonary artery, but there can be wide variability in the spatial relationships between the great arteries. Transposition of the great vesselswith ventricular septal defect. Transposition of great arteries linkedin slideshare. Cardiac surgery, kirklin jw, barrattboyes bg eds, churchill livingston, new york 1993. Transposition of great arteries dr amarja sachin nagre md,dm,fca. The aorta also tends to be on the right and anterior, and the great arteries are parallel rather than crossing as they do in the normal heart. Until aroud 1980 this delicate surgery could not be performed safely and an alternative procedure was used, redirecting blood within the atriums.
Cath lab examination of the patient with transposition of great arteries tga and intact ventricular septum ivs. In children with tga, these arteries are connected to the heart abnormally. The outflow tract in transposition of the great arteries. Transposition of the great arteries tga, also referred to as complete transposition, is a congenital cardiac malformation characterised by atrioventricular concordance and ventriculoarterial va discordance. Oxygenpoor blue blood returns to the right atrium from the body, passes through the right atrium and ventricle, then goes into the misconnected. Transposition of the great arteries tga, also referred to as complete transposition, is a congenital cardiac malformation characterised by atrioventricular concordance and ventriculoarterial va. You can see rashkind procedure and coronary arteries anatomy 2 r lad cx. The heart forms during the first 8 weeks of fetal development. Transposition of the great arteries tga is a group of congenital cardiac defects characterized by ventriculoarterial discordance. Potter transposition of the great arteries is classically divided into two types, complete transposition and corrected transposition.
Transposition of the great arteries description and epidemiology transposition of the great arteries tga is a cyanotic congenital heart defect in which the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, creating two parallel circuits. Support group for those living with congenitally corrected transposition of the great arteries. The eventually successful solution in the form of the now popular arterial switch operation aso was elucidated after multiple contributions from several surgical stalwarts and geniuses over more than 25 years table 1. In a structurally normal heart, the aorta arises from the left ventricle and the pulmonary artery pa arises from the. The aorta is connected to the hearts right ventricle instead of the left ventricle. Oxygenrich blood from the lungs is pumped through the aorta to the body and oxygenpoor blood from the body is pumped through the pulmonary artery to the lungs. Congenitally corrected transposition of the great arteries cctga is a rare heart defect in which the hearts lower half is reversed.