FAQ

Frequently Asked Questions

Understanding the Diagnosis

What is TGA?

Transposition of the great arteries (TGA) is a rare but serious heart defect present at birth where the two main arteries leaving the heart are reversed, which affects how oxygen-rich blood circulates through the body. There are two types: the more common form, d-TGA, usually causes low oxygen levels and is often diagnosed before or shortly after birth, and the less common form, l-TGA, which may not show symptoms right away and can vary depending on the heart’s structure and any related defects. In most cases, surgery soon after birth is needed to correct the artery positions and allow the heart to function properly.

How is TGA diagnosed?

Many cases are found during a routine prenatal ultrasound. If it’s not detected before birth, newborns often show signs like bluish skin (cyanosis), trouble breathing, or low oxygen levels. An echocardiogram (ultrasound of the heart) confirms the diagnosis.

Is TGA genetic?

For most families, TGA happens sporadically and is not inherited. Your cardiology team may offer genetic counseling if needed.

Can TGA happen with other heart defects?

Yes. Some babies with TGA may also have:

  • Ventricular septal defect (VSD)
  • Coronary artery differences
  • Other structural heart differences

These can affect surgical planning but are often treatable.

Before Surgery

What symptoms might my baby have before surgery?

Babies with TGA may:

  • Look blue or pale
  • Breathe rapidly
  • Have trouble feeding
  • Seem sleepy or less active

Doctors treat these symptoms right away to keep oxygen levels safe until surgery.

What treatments happen before surgery?

Newborns may receive:

  • Prostaglandin (PGE) to keep a blood vessel open for better oxygen mixing
  • Balloon atrial septostomy (a catheter procedure) to create or widen a small opening between the heart’s chambers

These steps stabilize the baby until the corrective surgery.

The Surgery

What is the main surgery to fix TGA?

The standard surgery is the arterial switch operation (also called the Jatene procedure). Surgeons switch the arteries to their correct positions and reconnect the coronary arteries. This usually happens within the first days to 1–2 weeks of life.

Is the surgery safe?

At experienced pediatric heart centers, the arterial switch operation is considered very safe and is the standard treatment for transposition of the great arteries. Today, most babies do very well with this surgery. Studies show deaths around the time of surgery are usually under about 4 to 5 percent at major centers, and long-term survival is excellent. Some long-term studies show survival around 95 to 97 percent at 20 to 25 years after surgery, and many patients grow up to live full, active lives. Outcomes have continued to improve over time as surgical techniques and ICU care have advanced. Many major congenital heart centers such as CHOP, Boston Children’s, Texas Children’s, and others perform this surgery regularly and have strong results. You can review one example of long-term outcomes data here: Children’s National Long-Term Outcomes.

What should I ask my care team?

Some helpful questions:

  • How many arterial switch surgeries does this hospital perform each year?
  • How will you monitor the coronary arteries after surgery?
  • What feeding or developmental support is available?
  • When should we schedule follow-ups?
  • Who should I call with concerns after we go home?

In the Hospital: Recovery & ICU

What will my baby look like after surgery in the ICU?

It can be overwhelming at first, but many of the tubes and monitors are there to help your baby heal and be closely monitored. You may see:

  • Breathing tube or oxygen support
  • Chest tubes to drain fluid
  • IV lines or central lines for medications and fluids
  • Heart monitoring wires and leads
  • Swelling or bandages around the chest incision

Your care team will explain each device and remove them as your baby improves.

What is ECMO and why would a baby with TGA need it?

ECMO is a machine that temporarily does the work of the heart and lungs to give the body time to recover. It is only used in critical situations and is not needed for most TGA patients. (I personally was on ECMO for a few weeks, but fully recovered and living a normal life.)

What is recovery like after surgery?

During recovery, the care team will monitor:

  • Heart rhythm
  • Oxygen levels
  • Feeding and weight gain
  • Healing of the incision
  • Heart function (via echo and EKG)

Most babies go home when they are eating well, gaining weight, and breathing comfortably on their own.

How long will my baby stay in the hospital?

Hospital stays vary, but many babies spend:

  • Several days in the cardiac ICU
  • 1–3 weeks in the hospital overall

Your team will update you daily with progress and milestones.

Will my baby have feeding difficulties after surgery?

Some babies do, especially early in recovery. Possible temporary supports include:

  • NG feeding tube
  • Feeding therapy or lactation support
  • Extra calorie fortification

Many babies improve feeding over time as they recover and gain strength.

Going Home & Life After Surgery

How can I support my baby at home after surgery?

  • Follow feeding and weight-gain instructions
  • Give medications exactly as prescribed
  • Keep incision areas clean and dry
  • Stick to follow-up appointments
  • Contact your care team for fever, breathing trouble, or feeding issues

Will my child need long-term follow-up?

Yes. Children who had the arterial switch should be followed regularly by a:

  • Pediatric cardiologist
  • Later, an Adult Congenital Heart Disease (ACHD) specialist

Follow-ups check the coronary arteries, valves, heart rhythm, and growth.

Will my child need more surgeries later in life?

Most children who undergo the arterial switch do not need additional surgeries. Some may require monitoring or treatment for:

  • Coronary artery narrowing
  • Aortic root dilation
  • Pulmonary artery narrowing
  • Heart rhythm abnormalities

Your cardiologist will track these over time.

Long-Term Outlook

Can children born with TGA live normal lives?

Yes. Many kids born with TGA grow up to:

  • Play sports
  • Go to school
  • Attend college
  • Have careers
  • Live completely normal lives

They may just need periodic heart checkups throughout life.

Does having TGA affect physical activity?

Most children are encouraged to be active. Your cardiologist will provide guidance based on your child’s heart function and test results, especially for competitive sports.

Are developmental delays or learning differences more common after congenital heart surgery?

Some children with complex congenital heart disease have a higher risk of learning or developmental differences. Early screening and early intervention services can make a big difference and help children reach their full potential.

Emotional Support & Resources

Is it normal to feel trauma, anxiety, or PTSD after my child’s diagnosis or surgery?

Yes. Many parents experience medical trauma, anxiety, or depression after a serious diagnosis or NICU stay. Talking to a therapist, joining support groups, or connecting with other heart families can be very helpful.

Are there support groups for families?

Yes! Many families find comfort and guidance through:

Talking to other parents who have been through TGA can be incredibly reassuring.

Where can I learn more?

Trusted sources include: