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Pediatric Transposition of the Great Arteries (TGA)


Children’s Health offers comprehensive care and treatment for all forms of congenital heart disease, no matter how rare. Physicians at Children’s Health are world-class subspecialists from UT Southwestern who provide advanced care for all forms of pediatric heart disease. 

Transposition of the great arteries (TGA) is a rare congenital heart defect that happens when the “great arteries” are switched (transposed):

  • The pulmonary artery carries oxygen-rich blood returning from the lungs right back to the lungs instead of carrying oxygen-poor blood from the heart to the lungs
  • The aorta carries oxygen poor blood back to the body instead of carrying oxygen rich blood from the heart to the body

As a result, oxygen-rich blood flows from the heart to the lungs but not to the rest of the body. In other words, your child’s organs are not receiving enough oxygen to work properly. 


Symptoms of Transposition of the Great Arteries

Children born with TGA appear normal at first but as they adjust to life outside the womb, which includes maintaining their own blood flow, they will quickly become sick.

Symptoms of TGA can start showing in the first few hours or days of life and can include:

  • Skin that appears ashen or blue from poor circulation (cyanosis)
  • Rapid breathing and shortness of breath
  • Rapid heart rate
  • Cool skin
  • Poor feeding
Tests and Diagnosis

Diagnosing Transposition of the Great Arteries

Prenatal diagnosis (before your child is born):

  • Prenatal screening ultrasounds can show early signs of abnormalities in your child’s heart
  • Specialized testing conducted by fetal heart experts can confirm your child’s diagnosis. Learn more about our fetal heart program
  • If your child does have TGA, we help you plan a safe delivery and make sure your child receives treatment immediately after birth

Postnatal diagnosis (after your child is born):

If your child’s condition was not diagnosed before they were born, we provide quick and accurate diagnosis once they start experiencing symptoms with the help of a physical exam and testing.

Your child’s physical evaluation may include:

  • Questions about growth, development, family history and any recent illnesses
  • Listening to the heart and lungs
  • Observing symptoms

Diagnostic testing may include:

  • Electrocardiogram (EKG)
  • Echocardiogram
  • Chest X-ray
  • Cardiac catheterization

At Children’s Health, we perform diagnostic tests using special imaging equipment designed with our smallest patients in mind. Learn more about the full spectrum of tests available from our cardiac imaging department.


Treating Transposition of the Great Arteries

At Children’s Health, we deliver compassionate care that meets your child’s every need. From the moment your child is born, we are ready to deliver life-saving treatments.

Treatments given to newborns provide temporary relief and may include:

  • Supplemental oxygen
  • A machine to help breathing (ventilator)
  • Intravenous (IV) medications or fluids
  • Medication to help keep connections between the aorta and pulmonary artery open allowing oxygen to pass to the organs (prostaglandin)
  • Balloon atrial septostomy, a catheterization procedure to widen an opening in the upper part of the heart, also allowing more oxygen to pass to the organs

Long-term treatment includes an open-heart surgical repair known as an arterial switch operation (ASO). Performed in the first months of life, ASO repairs heart defects by:

  • Separating the aorta and pulmonary artery from their roots and reattaching them in their proper places
  • Closing holes in the heart

Children’s Health delivers life-saving treatments for all forms of congenital heart disease, including TGA. Learn more about our cardiothoracic surgery program.


Transposition of the Great Arteries FAQs

Here are answers to some frequently asked questions:

What is TGA?

TGA occurs when the two “great arteries” – the pulmonary artery and the aorta – are switched (transposed).

What is happening in children with TGA?

TGA disrupts normal blood circulation, creating a closed loop that sends oxygen-rich blood back and forth from the heart to the lungs instead of out to the body and the brain. 

Who is most likely to get TGA and what causes it?

TGA affects more boys than girls (two-thirds of TGA patients are boys). Genetic and environmental factors might play a role, but in many cases, there is no known cause.

Is TGA dangerous?

Yes. Children with TGA struggle from the time they are born due to lack of oxygen. All children with TGA need open-heart surgery to repair the defect(s). 

Will my child need to have follow-up care/procedures?

Some children will need ongoing care for complications such as an irregular heartbeat (arrhythmia), which can occur years after surgical repair.  

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