Transposition of the great vessels
In transposition of the great vessels, the major blood vessels attached to the heart—the aorta and the pulmonary artery—are reversed. This reversal results in the blood going to the wrong places. This leads to low oxygen levels in the body.
The aorta, which normally carries oxygen-rich blood from the left side of the heart to the body, instead receives oxygen-poor blood from the right side of the heart. The pulmonary artery, which normally carries oxygen-poor blood from the right side of the heart to the lungs, instead receives oxygen-rich blood from the left side of the heart.
In transposition of the great vessels, the right lower chamber of the heart (rather than the left lower chamber) pumps blood to the body. But the right side of the heart normally is not strong enough to pump blood effectively to the whole body. This increased workload on the right side of the heart can lead to a weakened heart.
There are several types of transposition of the great vessels. Each has slightly different placement of the vessels and openings that result in mixing of blood between the two sides of the heart. The most common form of transposition of the great vessels results in oxygen-poor blood being pumped to the body.
Certain other heart problems must be present to allow a child with transposition of the great vessels to live. Other problems ultimately compensate for the transposition of the great vessels by allowing oxygen-rich blood to mix with oxygen-poor blood so that some oxygen can get to the tissues of the body. Surgery is usually needed for long-term survival.
What are the symptoms of transposition of the great arteries in newborns?
Some babies have few symptoms at first. But because the body isn't getting enough oxygen, symptoms may later include fast breathing and a blue tint to the skin, lips, or fingernails.
How is transposition of the great arteries in newborns treated?
Your doctor will help you understand your choices and what to expect from each choice.
Your baby may get medicine to keep the ductus arteriosus open. This helps keep red blood flowing to the body. It is often given through a blood vessel in the belly button.
Your doctor may do a treatment called cardiac catheterization. This procedure creates a hole between the upper chambers of the heart. This hole helps red blood mix with blue blood so the baby's body can get more oxygen. Your baby will be asleep during this procedure. The doctor puts a thin tube into a blood vessel in your baby's groin. This tube is called a catheter. The doctor moves the catheter through the blood vessel to the heart. The doctor moves special tools through the catheter to the heart to create the hole.
Open heart surgery is needed to cut and switch the two arteries. If there are other heart problems, they may be repaired at the same time.
What can you expect in the hospital if your newborn has transposition of the great arteries?
- You may see tubes and wires attached to your baby. This can be scary to see. But these things help the doctor treat your baby. The tubes supply air, fluid, and medicines to your baby. The wires are attached to machines that help the doctor keep track of your baby's vital signs. These include temperature, blood pressure, breathing rate, and pulse rate.
- The hospital staff will give your baby the nutrition that your baby needs. The doctor may feed your baby through a soft tube that goes through the nose and into the stomach. Or the doctor may use an I.V. that goes through the belly button to do this.
- Your baby may need oxygen. It is given to the baby through a tube in the nose or throat.
- Your baby will be kept comfortable and warm.
- It may seem that your baby is getting lots of tests. All of these tests help your doctor keep track of your baby's condition and give the best treatment possible.
- It's hard to be apart from your baby, especially when you worry about your baby's condition. Know that the hospital staff is well prepared to care for babies with this condition. They will do everything they can to help. If you need it, ask for support from friends and family. You can also ask the hospital staff about counseling and support.
How is transposition of the great arteries in newborns diagnosed?
Your doctor may hear abnormal heart sounds, such as a heart murmur, when they examine your newborn.
Your doctor will order tests to find the cause of abnormal sounds or of symptoms. The most common test used to identify this problem is called an echocardiogram, or "echo" for short. It uses sound waves to make an image of your baby's heart.
Other tests, such as an EKG (electrocardiogram), chest X-ray, and checking the amount of oxygen in the blood, also help identify the problem.
A fetal ultrasound, which looks at the baby's heart, may find this problem before birth.
How can you care for your newborn who has transposition of the great arteries?
Your doctor will make sure that you have all the information you need to take care of your baby. Your child's care team can show you how to help your baby. You can also ask the hospital staff about counseling and support.
What is transposition of the great arteries in newborns?
Transposition of the great arteries is a heart problem a baby is born with. The two main arteries—the aorta and the pulmonary artery—are switched. The aorta sends oxygen-rich blood to the lungs instead of the body. The pulmonary artery sends low-oxygen blood to the body instead of the lungs.
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