pediatrics
Transposition of the Great Arteries (TGA)
Key Points
In dextro-transposition of the great arteries (d-TGA), the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, resulting in independent pulmonary and systemic circulations. d-TGA is incompatible with life unless mixing of the circulations occurs through an atrial and/or ventricular septal opening, or a patent ductus. Severe cyanosis occurs within hours of birth, followed rapidly by metabolic acidosis; there are no murmurs unless other anomalies are present. Relieve cyanosis by giving prostaglandin E1 infusion to keep the ductus arteriosus open and sometimes by using a balloon catheter to enlarge the foramen ovale. Do definitive surgical repair during the first week of life. 