Arterial Switch for TGA
What is the arterial switch procedure for transposition of the great arteries (also known as transposition of the great vessels)?
The
arterial switch procedure is the surgery offered at the Inova
Heart Center to correct the congenital heart defect called
transposition of the great arteries (TGA or TGV). This heart
problem occurs when the aorta (the blood vessel that supplies
blood to the body) originates out of the right (instead of
the left) ventricle, while the pulmonary artery (the blood
vessel that transports blood to the lungs) originates out
of the left ventricle. The surgery is usually done in the
first two weeks of life.
Preparing for the procedure
Prior
to surgery, the baby will have had tests to diagnose the heart
defect including an EKG, a chest x-ray and an echocardiogram.
Either during the echocardiagram or through a cardiac catheterization,
the coronary arteries will be identified. If the baby needs
a bigger hole in the atrium to let the blood mix together,
a balloon
atrial septostomy may be performed. In addition, blood
tests to determine blood type and compatibility will be done
to prepare for the use of blood during surgery. Other blood
tests to be sure the baby is stable may also be done.
During the procedure
During
the procedure, the baby will be placed under general anesthesia
and special monitoring IVs will be used. The chest is opened
through the sternum (breastbone). The heart/lung machine is
connected. Once the heart is stopped and emptied, the aorta
and the pulmonary artery are divided. The coronary arteries
are then removed from their attachment to the aorta and moved
to their new location. The aorta and pulmonary arteries are
then switched back to connect to the appropriate ventricles.
The heart is then allowed to fill and take over its normal
function. Temporary pacemaker wires and drainage tubes are
then placed and the chest is closed. The baby is then allowed
to awaken from anesthesia slowly over the next few hours and
will stay on the respirator overnight until his or her breathing
is adequate and heart function has stabilized.
After the procedure
After surgery, the baby will need a number of days to recover from the surgery and anesthesia, and from the use of the heart-lung bypass machine. The baby will be on a ventilator (breathing machine) and may need support from IV medicines and a temporary pacemaker. Once the breathing tube (endotracheal tube) is out, one of main goals will be to encourage the baby to eat normally and gain weight.
Click here for recovery guidelines after discharge for congenital heart defect repair at the Inova Heart Center.
- Atrial Septal Defect (ASD) Repair
- Ventricular Septal Defect
- Tetralogy of Fallot Repair
- Arterial Switch for TGA
- Atrioventricular Canal Surgery
- Bidirectional Glenn
- Fontan
- Heart Valve Repair and Replacement
- Ross Procedure for AVR
- Patent Ductus Arteniosus
- Coarctation of the Aorta Repair
- Systemic to Pulmonary Shunt
- Pediatric Recovery
