Transposition of the Great Arteries
Basics
Description
Abnormal anatomic relationship between the great arteries and the ventricles in which the aorta arises from the anatomic right ventricle and the pulmonary artery arises from the anatomic left ventricle
Epidemiology
Incidence
Incidence is 20 to 30 per 100,000 live births, with a 60–70% male predilection.
Prevalence
Transposition of the great arteries (TGA) represents up to 7% of all cases of congenital heart disease.
Pathophysiology
- Systemic and pulmonary circulations are separated and function in parallel.
- Desaturated systemic venous blood is ejected from the right heart to the aorta, whereas the oxygenated pulmonary venous blood is ejected from the left ventricle into the lungs.
- Degree of hypoxemia depends on amount of intercirculatory mixing (patent ductus arteriosus [PDA], patent foramen ovale [PFO], ventricular septal defect [VSD]).
- Degree of left-to-right shunting is the effective systemic blood flow, whereas right-to-left shunting determines effective pulmonary flow.
Commonly Associated Conditions
- PDA and PFO with intact ventricular septum (50%)
- VSD (40%)
- Posterior malalignment VSD with left ventricular outflow tract obstruction (e.g., subpulmonic stenosis, pulmonary stenosis, pulmonary atresia) (10%)
- Anterior malalignment VSD with right ventricular outflow tract obstruction (e.g., subaortic stenosis, aortic stenosis, coarctation of the aorta, or interruption of the aortic arch) (10%)
- Leftward juxtaposition of the atrial appendages (5%)
- Straddling of the atrioventricular valve
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Citation
Cabana, Michael D., editor. "Transposition of the Great Arteries." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617158/all/Transposition_of_the_Great_Arteries.
Transposition of the Great Arteries. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617158/all/Transposition_of_the_Great_Arteries. Accessed October 11, 2024.
Transposition of the Great Arteries. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617158/all/Transposition_of_the_Great_Arteries
Transposition of the Great Arteries [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2024 October 11]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617158/all/Transposition_of_the_Great_Arteries.
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