Transposition of the Great Arteries

Transposition of the Great Arteries

When there is transposition of the great arteries, the patient suffers from a defect of the heart. Transposition of the great arteries is congenital and thus already present in newborns. It is typical of a transposition of the great arteries that the aorta emerges from the ventricle on the right, while the pulmonary trunk comes from the left.

What is a transposition of the great arteries?

The transposition of the great arteries is characterized by the inverse arrangement of the two main vessels at the ventricles of the heart. Basically, there is a separation of the systemic and pulmonary circulation in the context of the transposition of the large arteries. Many patients with a transposition of the large arteries also suffer from a defect in the ventricular septum or have what is known as pulmonary stenosis. For slang leiomyosarcoma, please visit electronicsencyclopedia.com.

If there are no other abnormalities in the anatomy of the heart, doctors speak of a simple transposition of the large arteries. Because the circulatory systems of the body and lungs are separate, the blood is not enriched with sufficient oxygen. The blood only mixes through the foramen ovale.

If the affected person has a defect in the ventricular septum at the same time, the oxygenation of the blood is usually better. The reason for this lies in a so-called shunt formation. But even in this case, the blood is not supplied with enough oxygen to supply the human organism with sufficient amounts.

Basically, the transposition of the great arteries is an inherent defect in the anatomy of the heart. The two major arteries are reversed. Due to the separation of the pulmonary and systemic circulation, the affected patients are in many cases not viable. Because the organism is permanently undersupplied with oxygen, so that it is not viable without therapy.

In principle, transposition of the great arteries accounts for about ten percent of all heart defects that are present in patients from birth. The transposition of the large arteries is possible on the one hand as an individual malformation of the heart, on the other hand in combination with other anomalies in its structure.

Pulmonary stenosis, for example, often occurs here, in which the artery valve of the lungs is narrowed. In some cases, other malformations appear, but these occur less frequently. Transposition of the great arteries often occurs in connection with heterotaxy.

Causes

Transposition of the great arteries is a congenital condition that develops in utero. For this reason, the heart defect is present from birth and poses an acute threat to life in newborns. The transposition of the large arteries usually develops at a certain stage of embryonic development.

Symptoms, Ailments & Signs

In the context of the transposition of the large arteries, various characteristic symptoms appear. A typical symptom is cyanosis, which develops in a few hours. The cause is the undersupply of the organism with oxygen. Even the administration of oxygen does not usually improve the condition of the affected patient.

If there is a defect in the ventricular septum along with the transposition of the great arteries, cyanosis in newborn babies is milder. In addition, other symptoms occur when the large arteries are transposed. In some cases, the thorax is bulging forward, or the affected patients suffer from tachypnea and tachycardia. The pulse is usually relatively weak.

After the birth, immediate treatment measures should be initiated. Because the symptoms of the transposition of the large arteries can quickly lead to a dangerous state of shock for the affected patient. It is characteristic of the transposition of the large arteries that there is a spatial confusion between the pulmonary artery and the aorta.

The life-threatening symptoms only become apparent after birth. As long as the embryo is in the mother’s abdomen, the lungs are not responsible for gas exchange. Instead, the blood inside the placenta becomes oxygenated.

Diagnosis & course of disease

Diagnosis of transposition of the great arteries is based on clinical symptoms. These appear immediately after birth and put the newborn patient in a life-threatening condition. Cyanosis is usually the first clue to the presence of transposition of the great arteries. At this early stage, however, other heart defects cannot be ruled out.

For this reason, an echocardiography is used, which usually allows a relatively reliable diagnosis. On the other hand, an X-ray examination of the chest is only partially suitable for diagnosis. Sometimes an examination with a cardiac catheter is also used. In this way, possible complications can be clarified.

Complications

Due to the transposition of the large arteries, those affected primarily suffer from a severe undersupply of oxygen. The skin turns blue and the affected person may also lose consciousness. Furthermore, the organs and the brain are damaged if the undersupply cannot be stopped in time.

Due to the transposition of the large arteries, those affected often feel weak and exhausted and can no longer carry out strenuous activities or sports. Confusion or disturbances in concentration and coordination can also occur as a result of this disease. Those affected may also lose consciousness and possibly injure themselves if they fall.

In many cases, the symptoms of transposition of the large arteries become apparent immediately after the child is born, leaving the child in a life-threatening condition. In the worst case, the child dies if this disease is not treated. Usually, transposition of the great arteries can be cured with surgery.

With early diagnosis and treatment, there are no complications. Life expectancy is then usually not reduced or restricted. Parents or relatives often also suffer from severe psychological problems with this disease and therefore need appropriate treatment.

When should you go to the doctor?

This health disorder is a congenital disease. Therefore, in most cases, it is noticed and diagnosed by members of the obstetric team immediately after the birth. It comes to optical abnormalities of the physique, which are already detected in newborns. Further examinations are automatically carried out by obstetricians and attending physicians. In most cases, therefore, parents do not have to initiate a visit to the doctor themselves.

If no corresponding diagnosis is made after birth, a doctor should be consulted as soon as irregularities and abnormalities in the behavior of the offspring occur. Peculiarities of the heart rhythm, visual changes in the chest area or a weak pulse are characteristic of the disease. Patients have a bulging chest that is a cause for concern. Restrictions in breathing, shallow breathing, gasping and tachycardia must be examined and treated.

Since the disease can lead to the premature death of those affected in severe cases, a doctor should be consulted as soon as possible at the first sign. The organism is undersupplied with oxygen, resulting in functional limitations, apathy or fatigue. A delayed reaction, listlessness and a pale complexion indicate that the affected person needs medical attention.

Treatment & Therapy

Transposition of the great arteries requires surgical intervention to save the patient’s life. The goal of the surgery is to reverse the two arteries. At the same time, correction of other deformities is possible. With a successful surgical correction of the transposition of the large arteries, the prognosis is usually relatively positive. Many patients have a long life expectancy.

Prevention

Transposition of the great arteries is congenital and there are no options for prevention.

Aftercare

Transposition of the great arteries (TGA) is always operated on. The operation mortality (up to 30 days after the operation) is around five percent. Late mortality (more than 30 days after the operation) tends towards two percent. Late mortality (from childhood to adulthood) amounts to around three percent of all cases of illness that have been operated on and survived in connection with the operation. In the event of the death of the affected child or adult (as a late consequence), the focus of aftercare is on coping with the grief.

Appropriate counseling and support services are provided for relatives in the first degree. The affected children recover quickly after the operation after the operation. Normal weight gain is to be expected. Nevertheless, the children operated on for TGA (up to 50 percent) suffer from a general developmental delay, which can sometimes be severe. After the operation, the observation of the motor and psychological development of the operated children is the focus of the follow-up care.

In addition, lifelong cardiological controls are necessary. An annual clinical or outpatient examination by a specialist is recommended here. Possible malformations of the heart can thus be detected and treated at an early stage. In addition, in individual cases up to 15 years after the first surgical intervention, the need for follow-up operations may arise. Outflow tract obstructions or aortic valve insufficiency rarely occur during this period.

You can do that yourself

If there is a transposition of the large arteries, a surgical intervention is usually necessary. The operation takes place in the first days or weeks of life. The most important self-help measure for the parents is regular talks with the clinic staff and friends and acquaintances.

Since it is a risky procedure, emotional support is necessary in any case. The doctor in charge can put you in touch with a suitable therapist. If the course is positive, the child should be closely observed after discharge from the clinic. Signs of complications must be clarified immediately. Sick children sometimes develop cardiac arrhythmias. Pacemaker use should be planned early to minimize the risk of complications.

Later in life, the child can be made aware of the condition. This creates awareness of the disease in the child and, in adulthood, it can independently take further measures to remain healthy despite the disease. Sick people would have to keep lifelong check-ups and also take endocarditis prophylaxis into account. Lifestyle needs to be adapted to heart disease in terms of physical activity, diet and career choices.

Transposition of the Great Arteries