When a baby is born with Transposition of the Great Arteries (TGA), the heart’s main arteries are switched, which prevents the body from getting enough oxygen. To correct this, the treatment typically follows these steps:
1. Stabilization immediately after birth
- To help babies get more oxygen, doctors may give a medication called prostaglandin that keeps a natural newborn blood vessel open and improves blood mixing until surgery can be done.
- Some babies undergo a balloon atrial septostomy. This catheter procedure creates or enlarges an opening between the upper chambers of the heart (atria) so that more oxygenated and de-oxygenated blood can mix, which improves oxygen levels until surgery.
2. Definitive surgery: the arterial switch operation
The standard corrective procedure is the arterial switch operation (sometimes called the “Jatene” procedure).
During the surgery:
- The aorta and pulmonary artery are moved to their correct positions (so the aorta comes off the left ventricle and the pulmonary artery on the right).
- The coronary arteries (which supply the heart muscle with blood) are carefully re-implanted so they continue to function normally.
- This operation is typically done in the first few days to 1-2 weeks of life, depending on the baby’s condition and hospital expertise.
- Post-operatively, the baby goes to a cardiac intensive-care unit, is monitored closely for heart rhythm, oxygen levels, feeding, and recovery.
3. Long-term follow-up
- Although the surgery corrects the anatomy, children need lifelong follow-up with congenital heart specialists (and later adult congenital heart disease, ACHD, programs) to monitor: coronary artery health, valve function, growth of vessels, heart rhythm, and physical activity guidelines.
- Many children go on to live active, normal lives, but check-ups are important to catch any late issues early.