TRANSPOSITION OF GREAT ARTERIES

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Last Updated : 6/28/2016
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Amar Taksande
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Medical
• Prostaglandin E1 infusion should be given to improve arterial oxygen saturation by reopening the ductus arteriosus. This is very important in patients with severe left ventricular outflow tract stenosis or atresia. Balloon atrial septostomy (“Rashkinds” Procedure) is a life- saving procedure which may be performed in children with any types of TGA with intact ventricular septum. The balloon atrial septostomy is used to increase the atrial level shunt and to improve mixing.

Surgical
Arterial switch operation (ASO): In this surgical operation, the pulmonary artery and aorta are transected above the arterial valves and switched over. Also, the coronary arteries have to be transferred across to the new aorta. Thus the left ventricle act as the systemic ventricle, pumping fully oxygenated blood into the aorta and the right ventricle assumes its normal pumping of blood to the lungs.
• In complex cases of transposition such as in those narrowing below the pulmonary valve, the ASO is not recommended. Alternative approaches are required whenever the arterial switch is not feasible.
• A repair at the atrial level, either by Mustard or Senning procedure, is usually suitable for hearts with an intact ventricular septum.
• If the VSD is large and non-restrictive and anatomy of coronary artery makes as an ASO inadvisable, a Rastelli-type of intracardiac repair may be feasible.



Contributor Information and Disclosures Amar Taksande
MD, FIAE, Fellowship in Paed. Cardiology
Jawaharlal Nehru Medical College, Sawangi ( Meghe), Wardha


First Created : 1/9/2001
Last Updated : 6/28/2016
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Last Updated : 6/28/2016
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