Transposition of the Great Arteries, Infant

Transposition of the great arteries is a heart defect that a baby is born with (congenital heart defect). If your baby has this condition, the two arteries that lead away from his or her heart (aorta and pulmonary artery) are in a reversed position (transposed).

In most cases, a baby with this condition will have surgery as an infant to repair the defect. The surgery (arterial switch procedure) is done to move the arteries back to their correct positions. Babies who have surgery for this defect may be at greater risk for certain problems later in life, such as problems with the heart rhythm or with heart pumping. Your baby will need to see a heart specialist (cardiologist) regularly so that his or her condition can be monitored.

What are the causes?

The exact cause of this condition is not known.

What increases the risk?

The following factors may make a baby more likely to have this condition:

Genetic factors.
Being born to a mother who is over the age of 40 at the time of pregnancy.
Being born to a mother who had the following during pregnancy:
- Uncontrolled diabetes.
- Certain viral illness.

What are the signs or symptoms?

Symptoms of this condition include:

Blue lips or skin.
Skin that is cool, pale, and moist.
Rapid breathing.
Difficulty breathing.
Rapid heartbeat.
Difficulty feeding.
Poor weight gain.

Symptoms may be present at birth, or they may not show up for several days or even weeks.

How is this diagnosed?

This condition may be diagnosed based on:

Your baby's symptoms and a physical exam. The health care provider will listen to your baby's heart for unusual sounds.
Various tests, such as:
- Blood tests.
- Imaging tests. These may include chest X-rays, an ultrasound of the heart (echocardiogram), a CT scan, or an MRI.
- Electrocardiogram (ECG) to measure the electrical activity of the heart.
Cardiac catheterization. This is a procedure in which a small, thin tube (catheter) is passed into a blood vessel near the heart and used to test blood movement and heart function.

This condition may be diagnosed before birth during a prenatal ultrasound.

How is this treated?

This condition is treated with surgery to put the arteries back in their correct positions. Surgery is usually done within a week or two after the baby is born. Before surgery, your baby may need supportive care, such as:

Use of a machine to help the baby breathe (ventilator).
Food and fluids given through an IV.
Medicine that helps to keep blood vessels open.
A procedure (balloon atrial septostomy) to create or increase the size of an opening in the wall between the two sides of the heart. This lets the blood mix more until surgery can be done.

Follow these instructions at home:

If your baby has surgery, follow instructions from your health care provider about home care after the procedure.

Keep all follow-up visits. This is important.

Contact a health care provider if:

Your baby is not gaining weight as expected.
Your baby has a fever.

Get help right away if:

Your baby's lips, fingers, or skin turns blue.
Your baby's skin feels cool and clammy.
Your baby is unusually tired.
Your baby has difficulty breathing or is breathing very quickly.
Your baby's heart is beating very quickly.
Your baby who is younger than 3 months has a temperature of 100°F (38°C) or higher.

Summary

Transposition of the great arteries is a heart defect that a baby is born with (congenital heart defect).
If your baby has this condition, the two arteries that lead away from his or her heart (aorta and pulmonary artery) are in a reversed position (transposed).
This condition is treated with surgery to put the arteries back in their correct positions. Surgery is usually done within a week or two after the baby is born.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.