Transposition of the Great Arteries

Abstract

d-TGA typically presents early after birth with severe cyanosis. Children with large VSD and d-TGA may present later without VSD, since mixing at the ventricular level in children with VSD allow better oxygenation. Second heart sound is single due to posteriorly positioned pulmonary valve rendering its closure inaudible. Children with d-TGA and intact ventricular septum will require prostaglandin infusion to maintain patency of ductus arteriosus. Balloon atrial septostomy (Rashkind procedure) is often needed in children with a small atrial communication to improve atrial level mixing of blood and therefore better oxygenation. Arterial switch procedure is performed during first 1–2 weeks of life. Atrial switch operation is no longer the procedure of choice. Lifelong followup is recommended for all patients after surgical repair. During follow up, branch pulmonary arterial stenosis is frequently encountered.