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Complete transposition of the great arteries (TGA) is a congenital heart defect in which the aorta fully, or almost fully, exits the right ventricle (RV) and the pulmonary artery fully, or almost fully, exists the left ventricle (LV).
The key sign is cyanosis, which is when there is a blueish cast to the skin. Cyanosis is more intense in cases of complete transposition of the great arteries where there is no ventricular septal defect (VSD).
It tends to be diagnosed before birth through foetal ultrasound. Around 70% of cases are diagnosed in the first few months of foetal development.
Complete transposition of the great arteries can be associated with other anomalies such as ventricular septal defect, pulmonary stenosis or aortic arch hypoplasia. In these cases it is known as “complex complete transposition of the great arteries”.
The severity of any related defects must be investigated to determine the best type of surgery in each case.
An arterial switch, anatomical correction or the Jatene procedure is the most commonly used technique to treat complete transposition of the great arteries at the neonatal stage. Through this technique, the pulmonary artery is connected to the right ventricle and the aorta to the left ventricle. The coronary arteries are also transferred to the new aorta.
Most patients reach adulthood without needing further procedures and with a quality of life comparable to the normal population.
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