Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 18 , ISSUE 1 ( January-March, 2024 ) > List of Articles


Transposition of the Great Arteries

Edin Medjedović, Milan Stanojevic, Sabaheta Jonuzovic-Prosic

Keywords : Congenital heart defect, Transposition of great vessels, Ultrasound

Citation Information : Medjedović E, Stanojevic M, Jonuzovic-Prosic S. Transposition of the Great Arteries. Donald School J Ultrasound Obstet Gynecol 2024; 18 (1):89-92.

DOI: 10.5005/jp-journals-10009-2007

License: CC BY-NC 4.0

Published Online: 28-03-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Transposition of the great arteries (TGA) is a conotruncal abnormality characterized by discordant ventriculoarterial alignments, with the aorta arising from the right ventricle and the pulmonary artery arising from the left ventricle and resultant parallel circulation of the systemic and pulmonary circuits. TGA can be dextro-TGA or levo-TGA based on the position of the aortic valve, right or left, regarding the pulmonary valve, and simple or complex TGA based on associated cardiac anomalies. With an incidence of 0.2–0.3/1,000 live births, TGA is the secondmost common cyanotic heart disease following the tetralogy of Fallot. Around 98% of TGA cases have a normal four-chamber view (4CV). The International Society of Ultrasound in Obstetrics and Gynecology and the American Institute of Ultrasound in Medicine added evaluation of the outflow tracts, three-vessel view (3VV), and three-vessel trachea view (3VTV) which improved the sensitivity of ultrasound screening for congenital heart disease (CHD). However, the prenatal detection rate of TGA, especially simple TGA, is generally low internationally, ranging from 25 to 50%. Without treatment, 50% of these infants die within the 1st month and 90% within the 1st year of life. The prenatal diagnosis of TGA improves postnatal outcomes through planned delivery at a tertiary care center and timely perinatal management. Immediately after birth, prostaglandin-E1 is given to keep the ductus arteriosus open to allow the mixing of oxygen-rich and oxygen-poor blood. If necessary, an atrial septostomy can be performed for short-term survival. Arterial switch operation (ASO) restores normal pulmonary and systemic circulation, with a 20-year survival rate of 90–97%.

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