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Symptoms & Causes

Transposition of the Great Arteries (TGA)

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What is Transposition of the Great arteries Arteries (TGA)?

What is Transposition of the Great arteries Arteries (TGA)?

Transposition of the great arteries (TGA) is a congenital heart defect where the aorta and the right ventricle are in the transposed (reversed) position compared to a normal heart. The aorta is connected to the right ventricle instead of the left, and the pulmonary artery is connected to the left instead of the right.

With transposition of the great arteries, blood flows the opposite way:

  • Oxygen-poor (blue) blood flows from the right ventricle through the aorta to the body, then returns to the right ventricle without going to the lungs.
  • Oxygen-rich (red) blood goes out of the left ventricle through the pulmonary artery to the lungs, then returns to the left ventricle without going to the body.

The abnormal flow of blood means your baby is not getting enough oxygen. Infants with TGA typically require surgery soon after birth.

Types of TGA heart conditions

Types

There are two types of transposition of the great arteries (TGA) conditions:

  • Dextro-transposition of the great arteries (d-TGA) is a heart condition that causes a shortage of oxygen-rich blood in the body. Symptoms can be noticed while the baby is in utero, immediately after birth, or within a few weeks after birth.
  • Levo-transposition of the great arteries (L-TGA) is the rarer form of TGA. With L-TGA, the heart ventricles are out of place, and the right ventricle has to do the blood pumping work usually done by the left. As a result, the overworked right ventricle becomes weakened. L-TGA is also referred to as congenitally corrected transposition.

TGA can be associated with other congenital heart defects such as atrial septal defect (ASD) and ventricular septal defect (VSD).

Signs & Symptoms of TGA

Symptoms

Signs of TGA generally appear at birth or very soon after, depending on the severity of the case. An infant with bluish color or breathing issues is usually diagnosed with TGA within the first week.

Common transposition of the great arteries symptoms can include:

  • Breathing problems
  • Weak pulse
  • Bluish or ashen skin color (cyanosis)
  • Trouble feeding
  • Poor weight gain

If an infant has other congenital heart defects, such as atrial septal or ventricular septal defects, blue skin color may not be as noticeable when they are born. As the baby grows more active, the bluish skin color will become more apparent due to the improper flow of oxygen.

If your baby is exhibiting any TGA symptoms, a pediatric cardiologist or heart specialist can provide a diagnosis and treatment.

More to explore

What Causes TGA?

Causes

The causes of transposition of the great arteries are unknown. TGA is a congenital heart condition that develops in your baby’s heart during pregnancy.

The heart forms during the first eight weeks. At some point in the middle of that timeframe, the aorta and the pulmonary arteries attach to the incorrect heart chamber.

Risk Factors

Risk Factors

Though the causes of TGA are unknown, certain factors could increase the risk of a baby developing the condition. A combination of genetic, environmental, and behavioral issues in a pregnant woman could come into play, including:

  • German measles (rubella) or other viral illnesses in the mother during pregnancy
  • Smoking while pregnant
  • Drinking alcohol during pregnancy
  • Taking certain medications while pregnant
  • Mothers with poorly monitored type 1 diabetes

Complications

Complications

Complications from d-TGA can include:

  • Heart failure. In d-TGA, the right lower ventricle is working too hard to pump blood. This can weaken or stiffen the ventricle, resulting in congestive heart failure.
  • Lack of oxygen to body tissue. If the body tissue does not receive enough oxygen, the outcome can be fatal.

Complications from L-TGA can include:

  • Heart valve disease. In TGA, the valve between the lower and upper heart chambers may not close completely. This causes the blood flow to go backward (tricuspid valve regurgitation), resulting in the heart muscle pumping ineffectively.
  • Complete heart block. The abnormal structure of a heart with L-TGA can cause disruptions in the electrical signals that tell the heart to beat.

Prevention

Prevention

Any baby can develop transposition of the great arteries. But mothers-to-be can take precautionary steps to have a healthy pregnancy, including:

  • Speak with a specialist. If you are newly pregnant or planning to become pregnant, talk to a genetic counselor or cardiac specialist, especially if you have congenital heart defects in your family history or already have a child with TGA.
  • Immunizations. Be sure to stay up to date on recommended vaccinations.
  • Folic acid. Consider taking a multivitamin with 400 micrograms of folic acid. It may help prevent birth defects.
Get Care

Trust NewYork-Presbyterian for TGA Cardiac Care

The NewYork-Presbyterian Congenital Heart Center is home to some of the finest pediatric cardiologists in the nation. Our doctors and specialists can provide treatment options for TGA and other types of congenital heart disease, including access to expert surgeons and a supportive pediatric heart care team.

For the best in compassionate cardiac solutions, reach out to NewYork-Presbyterian for an appointment.