
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Transposition of the great vessels medical therapy
Introduction
Overview
Overview
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.
Medical Therapy
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.[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
- 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.
Life Style Modifications
Life Style Modifications
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.
2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[3]
2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[3]
Therapeutic Recommendations for d-TGA With Atrial Switch
| Class I |
| 1.GDMT with appropriate attention to the need for anticoagulation is recommended to promptly restore sinus rhythm for adults with d-TGA with atrial switch repair presenting with atrial arrhythmia.(Level of Evidence: B-NR) |
References
References
- ↑ Unolt M, Putotto C, Silvestri LM, Marino D, Scarabotti A, Valerio M, Caiaro A, Versacci P, Marino B (June 2013). “Transposition of great arteries: new insights into the pathogenesis”. Front Pediatr. 1: 11. doi:10.3389/fped.2013.00011. PMC 3860888. PMID 24400257. Vancouver style error: initials (help)
- ↑ Shah S, Gupta T, Ahmad R (2015). “Managing Heart Failure in Transposition of the Great Arteries”. Ochsner J. 15 (3): 290–6. PMC 4569166. PMID 26413006.
- ↑ Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM; et al. (2019). “2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines”. J Am Coll Cardiol. 73 (12): 1494–1563. doi:10.1016/j.jacc.2018.08.1028. PMID 30121240.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Kristin Feeney, B.S. [5]
