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Concept
Dextro-Transposition of the great arteries
Summary
dextro-Transposition of the great arteries (d-Transposition of the great arteries, dextro-TGA, or d-TGA) is a potentially life-threatening birth defect in the large arteries of the heart. The primary arteries (the aorta and the pulmonary artery) are transposed.
It is called a cyanotic congenital heart defect (CHD) because the newborn infant turns blue from lack of oxygen. In segmental analysis, this condition is described as ventriculoarterial discordance with atrioventricular concordance, or just ventriculoarterial discordance. d-TGA is often referred to simply as transposition of the great arteries (TGA); however, TGA is a more general term which may also refer to levo-transposition of the great arteries (l-TGA).Another term commonly used to refer to both d-TGA and l-TGA is transposition of the great vessels (TGV), although this term might have an even broader meaning than TGA.
Prenatally, a baby with d-TGA experiences no symptoms as the lungs will not be used until after birth, and oxygen is provided by the mother via the placenta and umbilical cord; in order for the red blood to bypass the lungs in utero, the fetal heart has two shunts that begin to close when the newborn starts breathing; these are the foramen ovale and the ductus arteriosus. The foramen ovale is a hole in the atrial septum which allows blood from the right atrium to flow into the left atrium; after birth, the left atrium will be filled with blood returning from the lungs and the foramen ovale will close. The ductus arteriosus is a small, artery-like structure which allows blood to flow from the trunk of the pulmonary artery into the aorta; after birth, the blood in the pulmonary artery will flow into the lungs and the ductus arteriosus will close. Sometimes these shunts will fail to close after birth; these defects are called patent foramen ovale and patent ductus arteriosus, and either may occur independently, or in combination with one another, or with d-TGA or other heart and/or general defects.
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