Arterial Switch Operation for Transposition of Great Arteries: A Patient’s Guide
According to demographic data, the rate of heart disease among Indians is double that of the national average in the western world. Apart from CVD (cardiovascular disease) in young adults and the elderly population, there are various congenital anomalies that require immediate cardiac intervention (heart treatment). Transposition of the great arteries (TGA) is one such congenital(inborn) heart anomaly. And we believe if you’re here on this page, then you might have heard the term "arterial switch operation" from your doctor or heart specialist. The operation is performed to treat such anomalies. Here we’ve discussed the procedure in detail with the help of our experts, along with some common queries related to the same.
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What do you mean by the transposition of great arteries?
The transposition of great arteries is an umbrella term for various congenital anomalies (inborn heart disorders) where the major blood vessels of the heart have switched places.
The aorta and pulmonary arteries are referred to as the "great arteries" in this defect. These are the two main arteries that drain blood from the heart.
Transposition of the great arteries occurs when these vessels begin in the wrong ventricle. They have been "transposed" from their original position. The aorta originates in the right ventricle, while the pulmonary artery originates in the left ventricle.
Transposition causes the systemic (to the body) and pulmonary (to the lungs) circulations to work in tandem rather than together. This means that the oxygen-depleted ("blue") blood that is returning from the body and passing through the right atrium and right ventricle is pumped out to the aorta and the body.
The pulmonary artery sends oxygen-rich ("red") blood returning from the lungs and passing through the left atrium and ventricle back to the lungs.
Hence, the organs of the body will not get enough oxygen that they need to function properly.
What are the signs and symptoms of transposition?
The signs of transposition can be detected while doing regular screening tests like ultrasound during pregnancy.
The following are the symptoms of transposition that can be observed right after birth:
- Cyanosis (blue color of the skin)
- Weak pulse
- Shortness of breath
- Poor appetite
- Weight loss
- Pounding heart
In babies born with transposition of the great arteries and other congenital heart defects, blue skin color may be less noticeable at first. This is due to the fact that other heart conditions, such as atrial septal defects, ventricular septal defects, or patent ductus arteriosus, may allow some oxygen-rich blood to enter the body. However, as the baby grows more active, the congenital heart defects will prevent enough blood from passing through, and the blue skin color will become visible.
Treatment options available for transposition:
There are various surgical treatments available for the transposition of great arteries. However, the type of treatment may vary based on multiple factors, like:
- Age of the patient
- The overall health of the patient
However, most of these surgeries are open surgeries that require entering the chest to reach the heart. The two main options are:
- Arterial switch operation: The aorta and pulmonary arteries are severed and moved to their proper positions during this procedure. In most cases, it is regarded as the preferred option. Any holes in the heart may be sutured or allowed to close on their own during surgery if they are small.
- Atrial switch surgery: This procedure involves creating a tunnel (baffle) between the heart's two upper chambers (atria). This allows deoxygenated blood to enter the lungs and oxygenated blood to enter the aorta for distribution to the rest of the body.
How is transposition treated with an arterial switch operation?
An arterial switch is a surgical procedure and the primary treatment for great artery transposition (TGA). Almost all TGA children have their arterial switches repaired (also called the Jatene repair).
Babies with TGA become extremely ill soon after birth due to a severe lack of oxygen. Two temporary measures can improve your baby's condition before proceeding with an arterial switch:
- Beginning a medication known as prostaglandin
- Carrying out a balloon atrial septostomy
An arterial switch procedure is a type of open heart surgery that is typically performed within the first week of life.
How can we help with the treatment?
If you are in search of treatment for heart transplant for your child, we will serve as your guide throughout the treatment and will be physically present with you even before your child’s treatment begins. The following will be provided to you:
- Opinions of expert physicians and surgeons
- Transparent communication
- Coordinated care
- Prior appointment with specialists
- Assistance with hospital formalities
- 24*7 availability
- Arrangement for travel
- Assistance for accommodation and healthy recovery
- Assistance in emergencies
We are dedicated to offering the highest quality health care to our patients. We have a team of highly qualified and devoted health trip advisors that will be by your side from the beginning of your journey.