PRESENTED BY:L Premeshwori DeviM.Sc nursing 2nd year

The transposition of the great arteries is ventriculo arterial discordance, in which the aorta arises from the morphologic right ventricle and the pulmonary artery arises from the morphologic left ventricle.

Transposition of the great arteries (TGA) is the most common cyanotic congenital heart lesion that presents in neonates.This lesion presents in 5-7% of all patients with congenital heart disease. The overall annual incidence is 20-30 per 100,000 live births.

A history of German measles (rubella) or another viral illness in the mother during pregnancy A family history of transposition of the great arteries or another congenital heart defect Poor nutrition during pregnancy Drinking alcohol during pregnancy A mother older than age 40 A mother who has poorly controlled diabetes Down syndrome in the baby

Etiology for transposition of the great arteries is unknown and is presumed to be multifactorial.This congenital heart defect is more common ininfants of diabetic mothers.

(The pulmonary and systemic circulations function in parallel, rather than in series) Causes

Transposition of great arteries

Oxygenated pulmonary venous blood returns to the left atrium and left ventricle

Recirculated to the pulmonary vascular bed via the abnormal pulmonary arterial connection to the left ventricle.

Deoxygenated systemic venous blood returns to the right atrium and right ventricle

pumped to the systemic circulation, effectively bypassing the lungs deficient oxygen supply to the tissues and an excessive right and left ventricular workload

It is incompatible with prolonged survival unless mixing of oxygenated and deoxygenated blood occurs at some anatomic level likeASDVSDPDA

Prominent and progressive cyanosis within the first 24 hours of life is the usual finding in infants.TachypneaTachycardia DiaphoresisFailure to gain weight

History collectionPhysical examinationABG analysisEchocardiographyCardiac catheterization

Chest radiography

demonstrate the classic "egg on a string" appearance in approximately one third of patients.

Immediate management includesEstablishing safe oxygen level and maintaining stable cardiac and pulmonary function.

Initial treatment consists of continuous intravenous (IV) prostaglandininfusion to promote pulmonary blood flow.Antibiotic Prophylactic Regimens for Endocarditis.Fluid replacement Bicarbonate administration- AcidosisMechanical ventilation

Ballon atrial septostomy.Arterial switch procedure

Congestive heart failureArrhythmiaEisenmenger syndrome (irreversible and progressive pulmonary vascular obstructive disease)

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