Transposition Of The Great Arteries
Transposition of the great arteries (TGA) is a congenital heart defect characterized by the incorrect positioning of the aorta and pulmonary artery, the two major arteries that emerge from the heart. In this condition, oxygen-poor blood returns to the body, while oxygen-rich blood is sent back to the lungs, resulting in severe oxygen deprivation for the body. TGA is often detected through prenatal ultrasounds during pregnancy or shortly after birth. If left untreated, it can lead to serious complications and even death. The primary treatment for TGA is corrective surgery, usually performed within the first few weeks of life, to reposition the coronary arteries properly. While surgical intervention can successfully repair the defect, lifelong follow-up care is essential to monitor heart function and manage any potential complications that may arise over time.
About Transposition of the Great Arteries (TGA)
Symptoms: TGA typically presents with symptoms such as cyanosis (a bluish discoloration of the skin), rapid breathing, and difficulty feeding. These symptoms result from the misalignment of the aorta and pulmonary artery, leading to inadequate oxygenation of the blood.
Causes: TGA occurs during foetal development when there is an abnormal connection between the pulmonary arteries and the aorta. While the exact cause is unknown, it is believed that a combination of environmental and genetic factors contributes to this congenital heart defect.
Treatments: The primary treatment for TGA is corrective surgery, which is usually performed shortly after birth. This surgery involves repositioning the aorta and pulmonary artery to improve oxygenation and restore normal blood circulation. Lifelong follow-up care is essential for managing TGA and monitoring any potential complications.
Procedure of Transposition of the Great Arteries
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Preoperative Evaluation: The patient undergoes a comprehensive assessment that includes imaging scans and cardiac tests to determine the extent of the anomaly and to plan the surgical approach.
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Anaesthesia: General anaesthesia is administered to ensure the patient’s comfort and immobilisation during the procedure.
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Surgical Incision: The surgeon makes an incision in the chest to access the heart and its surrounding structures. The location and size of the incision depend on the surgical technique chosen by the heart surgeon.
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Cardiopulmonary Bypass: The patient is connected to a heart-lung bypass machine, which temporarily takes over the functions of the heart and lungs. This allows the surgeon to operate on the heart while maintaining blood circulation and oxygenation.
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Arterial Switch Operation: The surgeon carefully disconnects and repositions the pulmonary artery and aorta to restore their proper alignment, effectively correcting the abnormal blood flow associated with TGA.
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Closure: After repositioning the arteries, the surgeon closes the incisions in the chest and gradually weans the patient off the cardiopulmonary bypass machine.
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Postoperative Care: Following surgery, the patient is closely monitored in the intensive care unit (ICU) or cardiac recovery unit. Pain management, ventilation support, and necessary medications are provided. The medical team assesses the patient’s recovery and addresses any complications that may arise. Regular follow-up appointments are scheduled to monitor progress and ensure optimal outcomes.