Dextrotransposition pronounced deckstro transpohzishun of the great arteries or dtga is a birth defect of the heart in which the two main arteries carrying blood out of the heart the main pulmonary artery and the aorta are switched in position, or transposed. The incidence is estimated at 1 in 3,5005,000 live births, with a maletofemale ratio 1. The management and outcome of dtga are discussed separately. Transposition of the great arteries tga arterial switch operation aso jatene operation. 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 transposition of the great arteries or tga is a potentially fatal congenital heart malformation where the pulmonary artery and the aorta are switched. Although reference was made to malposition of the aorta and pulmonary artery by steno in 1672 and morgagni in 1761, the anatomic description of tga is credited to baillie in 1797. The great arteries are divided and followed by a lecompte maneuver.
Great arteries vessels transposition of the great arteries, or tga, is a rare congenital heart defect the baby is born with it in which the two main arteries carrying blood out of the heart are switched in position. Levo transposition of the great arteries ltga is a rarer condition in which not only the aorta and pulmonary arteries are switched but also the lower chambers of the heart called the ventricles. Because a baby with this defect may need surgery or other procedures soon after birth, dtga is. 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. Jun 27, 2011 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. Corrective surgery soon after birth is the usual treatment for transposition of the great arteries. See management and outcome of d transposition of the great arteries. The most common form of tga is referred to as dextrotga dtga which is.
Normally, the pulmonary valve is anterior and to the left of the aortic valve. Khan academy is a nonprofit with the mission of providing a free, worldclass education for anyone, anywhere. The pulmonary artery arises from the right ventricle and the aortic valve arises from the. Transposition of the great arteries radiology reference. Learn for free about math, art, computer programming, economics, physics, chemistry, biology, medicine, finance, history, and more.
Aug 11, 2018 transposition of the great arteries is usually detected either prenatally or within the first hours to weeks of life. Facts about dextrotransposition of the great arteries dtga. Having a baby with transposition of the great arteries can be alarming, but with proper treatment, the outlook is promising. Read on for information about the characteristics of the defect at birth and the treatment and followup care that is necessary into adulthood. The aorta receives the oxygenpoor blood from the right ventricle, but its carried. Babies with tga may need surgery or other procedures soon after birth, so tga is considered a critical congenital heart disease.
Transposition of the great arteries in this case, dextro transposition occurs when the aorta arises directly from the right ventricle and the pulmonary artery arises from the left ventricle, resulting in independent, parallel pulmonary and systemic circulations. Transposition of the great arteries or vessels tga tgv what is transposition of the great arteries vessels. Apr 11, 2017 transposition of the great arteries tga is the most common cyanotic congenital heart lesion that presents in neonates. Jun 06, 20 transposition of great arteries tga is one of the most common and severe congenital heart diseases chd. Other heart defects may occur along with transposition of the great arteries. Dextro transposition of the great arteries d tga occurs when the position of the main pulmonary artery and aorta are switched. Pdf transposition of the great arteries tga, also referred to as complete transposition, is a congenital cardiac malformation characterised by. The arterial switch operation aso has replaced atrial switch procedures. Overall annual incidence is 2030 per 100,000 live births, tga is isolated in 90% of patients rarely associated with syndromes or extracardiac malformations. Clinical guidelines for the management of patients with transposition. Sep 09, 2008 complete transposition of the great arteries d tga richard krasuski, md duration.
In cases of transposition of the great arteries aorta and pulmonary artery, these vessels are transposed from their normal position so that the aorta arises from the right ventricle and the. Recent studies reported convincing results of the aso for tga with an intact ventricular septum in the long term. Transposition of the great arteries description and epidemiology. It is also one of the most mysterious chd because it has no precedent in phylogenetic. Transposition of the great arteries diagnosis and treatment. In this condition, the large blood vessels that carry blood from the heart to the lungs and body arent connected as they should be. The pathophysiology, clinical features, diagnosis, and management of ltga will be presented here. The two major arteries that carry blood away from the heart the aorta and the pulmonary artery are switched transposed. Longterm outcomes of the arterial switch operation for. According to this segmental approach, this case may is classified as s,d, dtga, referring to the situs solitus, dvenricular loop and d transposition of the great arteries. Oct, 2008 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. Transposition of the great arteries statpearls ncbi bookshelf. Simple in concept, the aso remains one of the most complex neonatal operations. The prefixes a, d and l transposition describe the spatial relationship between the aorta and the pulmonary trunk, and should not be used to.
Many infants undergo a procedure in the catheterization laboratory to buy time and delay the surgery until they can handle it better. Although its possible your babys transposition of the great arteries may be diagnosed before birth, it can be difficult to diagnose. Evaluation of a comprehensive cardiovascular magnetic. The pathophysiology, clinical features, and diagnosis of dtga of the great arteries will be presented here. Complete transposition of the great arteries with complete transposition tga, also defined as d transposition, atrioventricular con cordance and ventriculoarterial discordance, and transpositions,d,d, the systemic and pulmo nary veins, atria, and ventricles are normally aligned, but the aorta arises from the right ventricle and the. Pdf transposition of the great arteries researchgate. In this observational study we aimed to determine the value of a comprehensive cardiovascular magnetic resonance cmr protocol for the detection of coronary problems in adults with. Patients are transferred on high fio2, with a manual resusci.
Heart murmurs associated with left outflow tract obstruc. In cases of transposition of the great arteries, these vessels arise from the wrong ventricle. The prevalence of tga in the united states is estimated to be 4. This paper aims to update clinicians on hot topics in the management of patients with dtransposition of the great arteries dtga in the current surgical era. Transposition of the great arteries tga refers to hearts with. Prenatal tests for transposition of the great arteries arent usually done unless your doctor suspects your baby may have congenital heart disease. Transposition of the great arteries, dtype congenital. D transposition of the great arteries is a form of congenital heart disease that must be corrected shortly after birth for survival. The switch means that the aorta, which normally carries. Houston methodist debakey cv education 2,035 views. Transposition of the great arteries symptoms and causes. 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. See pathophysiology, clinical manifestations, and diagnosis of d transposition of the great arteries and management and outcome of d transposition of the great arteries.
There are two forms, d transposition, the subject of this thesis, and ltransposition or congenitally corrected transposition. Transposition of the great arteries orphanet journal of rare. The arterial switch operation aso is the procedure of choice for treatment of most forms of transposition of the great arteries tga. Transposition of the great arteries tga the embryo. Transposition of the great arteries tga is a pediatric cardiac congenital. Transposition of the great arteries tga is a heart defect that occurs from birth. Transposition of the great arteries transposition of the great arteries is characterized by anomalous ventriculoarterial connections. They are transposed from their normal position so that the aorta arises from the right ventricle and the pulmonary artery from the left ventricle. Transposition of the great arteries tga pediatrics msd. More information for parents of children with d transposition what about surgical treatment. Transposition of the great arteries 0 university of chicago. Introduction tga most common etiology for cyanotic congenital heart disease in the newborn.
Transposition of the great arteries tga, also referred to as complete transposition, is a congenital cardiac malformation characterised by atrioventricular concordance and ventriculoarterial va. After transferring the coronary arteries, the surgeon reconnects the great arteries to the proper ventricle and closes any intracardiac communication. In this defect, which accounts for 5% of the cases of congenital heart disease, the two main arteries aorta and pulmonary artery are connected to the wrong chambers of the heart. 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. Complete transposition of the great arteries dtga richard krasuski, md duration. Transposition of the great arteries with intact ventricular. Dtransposition of the great arteriesa new era in cardiology. This condition is more common among males, affecting 3 boys to every 1 girl. Transposition of the great arteries tga also known as transposition of the great vessels tgv is the most common cyanotic congenital cardiac anomal y presenting during the newborn period, with cyanosis in the first 24 hours of life. Transposition of the great arteries tga is a type of congental heart defect. 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 video khan academy. What is dextrotransposition of the great arteries dtga. Preoperative physiology, imaging, and management of. It is also one of the most mysterious chd because it has no precedent in phylogenetic and ontogenetic development, it does not represent an alternative. Dextrotransposition of the great arteries or dtga is a birth defect of the heart in which the two main arteries carrying blood out of the heart the main pulmonary artery and the aorta are switched in position, or transposed. Transposition of the great arteries, dtype rollover to compare with normal what is it. Transposition of the great arteries dtga radiology case. Journal of the american college of cardiology, 645, 498511. In transposition of the great arteries, the aorta and pulmonary artery are reversed. Incidence of stroke in patients with d transposition of the great arteries that undergo balloon atrial septostomy. Normally, there are two separate blood vessels leaving the heart.
Transposition of the great arteries tga was first recognized and described more than 2 centuries ago. Transposition of the great arteries or vessels tga tgv. Complete transposition of the great arteries is also known as dtga. Intermediate results from the period of the congenital heart. Levotransposition of the great arteries ltga, occasionally referred to as congenitally correctedtga, describes an anatomical abnormality in which the morphological left ventricle is on the right side of the heart. Patients with transposition of the great arteries require surgery early in life to survive. Transposition of the great vessels tgv is a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels.
The patient population was derived from the files of the departments of cardiology and surgery. Aug 05, 2014 this paper aims to update clinicians on hot topics in the management of patients with d transposition of the great arteries dtga in the current surgical era. Article information, pdf download for preoperative physiology. Dec 11, 2014 in adults with prior arterial switch operation aso for d transposition of the great arteries, the need for routine coronary artery assessment and evaluation for silent myocardial ischemia is not well defined. Transposition of the great arteries genetic and rare. May 29, 2015 the recurrence risk in firstdegree relatives of patients with transposition of the great arteries tga is low compared to other conotruncal defects.
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