Transposition of the great vessels medical therapy

Surgery is the mainstay of treatment for TGA. However, infusion of PGE1 to a newborn diagnosed with TGA is recommended as it prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.

Surgery is the mainstay of treatment for TGA. However, infusion of PGE1 to a newborn diagnosed with TGA is recommended as it prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.^[1][2]

• Prostaglandins (PGE)
  • Prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.
• Antibiotics
  • Antibiotics may be administered preventively. However, due to the physical strain caused by uncorrected d-TGA, as well as the potential for introduction of bacteria via arterial and central lines, infection is not uncommon in pre-operative patients.
• Diuretics
  • Diuretics aid in flushing excess fluid from the body, thereby easing strain on the heart.
• Analgesics
  • Analgesics normally are not used pre-operatively, but they may be used in certain cases. They are occasionally used partially for their sedative effects.
• Cardiac glycosides
  • Cardiac glycosides are used to maintain proper heart rhythm while increasing the strength of each contraction.
• Sedatives
  • Sedatives may be used palliatively to prevent a young child from thrashing about or pulling out any of their lines.

Patients with transposition of the great arteries and a large ventricular septal defect who have not undergone repair may require certain life style modifications to control symptoms which include:

• Increased caloric density during infancy (particularly if they have significant congestive heart failure and poor weight gain).
  • Following definitive repair, most patients do not need a special diet.

• Specific activity restrictions are dependent on the patient’s residual hemodynamic abnormalities.
• Following the arterial switch procedure, exercise stress testing is necessary in older patients who are interested in participating in competitive sports.

Template:WH Template:WS