TGA : Understanding the Condition & Life-Saving Treatments

You might have seen babies who appear bluish just after birth. This bluish tint is most noticeable in areas where the skin is thin—such as the lips, fingers, earlobes, and nail beds. It can be a sign of a serious heart condition called transposition of the great arteries, or TGA.

TGA is a type of congenital heart defect, meaning it's present from birth. In this condition, the blood flow inside the heart doesn’t function the way it should. As a result, the baby’s body doesn’t receive enough oxygen. This can lead to symptoms such as difficulty breathing, trouble feeding, or excessive sleepiness—all of which can be deeply worrying for new parents.

If your baby has just been diagnosed with TGA, don’t panic. The more you understand about this condition, the more confident you'll feel in making informed decisions about treatment. In this guide, we’ll explain to you everything you need to know about transposition of the great arteries—from what it is to how it’s treated. And if your child is also suffering from this condition, you can consult with the Best Pediatric Cardiologist in Kolkata at BM Birla Hospital.

What is transposition of the great arteries?

Transposition of the Great Arteries (TGA) is a congenital heart defect, meaning it’s present from birth. In this condition, the two main arteries that carry blood out of the heart are swapped or “transposed”.

Here’s what normally happens:

• The aorta carries oxygen-rich blood from the left side of the heart to the body.
• The pulmonary artery carries oxygen-poor blood from the right side of the heart to the lungs.

In babies with TGA, these arteries are connected to the wrong sides of the heart:

• The aorta is connected to the right side, sending oxygen-poor blood to the body.
• The pulmonary artery is connected to the left side, sending oxygen-rich blood back to the lungs.

As a result, the oxygen-poor and oxygen-rich blood systems run in parallel instead of mixing properly. This means your baby’s body doesn’t get the oxygen it needs, which can be life-threatening without medical intervention.

What are the symptoms of transposition of the great arteries?

Symptoms of TGA usually appear very soon after birth, often within hours. The most noticeable sign is cyanosis, a bluish tint to the skin, lips, or fingertips due to low oxygen levels. Other symptoms include:

• Difficulty breathing or rapid breathing
• Poor feeding or refusing to feed
• Excessive sleepiness or lethargy
• Cold hands and feet

In some cases, a heart murmur may also be detected.

Not every baby will show all of these signs, but if any of them are present, doctors will act quickly to investigate further.

Major Causes and Risk Factors of TGA

TGA often occurs without a clear reason, but some risk factors have been identified. These include:

• Maternal diabetes, particularly if poorly controlled during pregnancy
• Genetic conditions or a family history of congenital heart defects
• Maternal age or certain medications used during pregnancy
• Environmental factors, though research is ongoing

It’s important to remember: TGA is not your fault. Most of the time, it happens without warning and couldn’t have been prevented.

How is TGA Diagnosed? Screening and Tests

Early diagnosis is vital. Thanks to modern technology, including AI-assisted imaging, doctors are now better equipped than ever to detect congenital heart defects early—even before birth. Diagnosis may happen in two main ways:

Before birth (prenatal diagnosis):

• A detailed foetal ultrasound or foetal echocardiogram can sometimes detect TGA during pregnancy, especially if there’s a known risk factor.
• Some centres now use AI tools to analyse scan images more accurately, helping doctors spot subtle heart abnormalities earlier and with greater precision.

After birth:

• If a newborn shows symptoms like cyanosis, doctors will do a pulse oximetry test to check oxygen levels.
• An echocardiogram (a heart ultrasound) confirms the diagnosis by showing the structure of the heart and how blood is flowing.
• Additional tests like chest X-rays or ECGs may support the diagnosis.

Quick and accurate testing makes a huge difference, and AI now plays a helpful role in supporting paediatric cardiologists during this process.

Treatment Options for Transposition of the Great Arteries

The good news? TGA is treatable, and many children go on to live active, healthy lives after receiving the right care. Treatment often begins within the first few days of life and usually includes surgery.

Here’s how it’s typically managed:

Initial stabilisation:

• Doctors may give a medication called prostaglandin to keep a natural heart passage (the ductus arteriosus) open, allowing some mixing of oxygen-rich and poor blood.
• In some cases, a balloon atrial septostomy is done to create or widen a hole between the heart's upper chambers, helping improve oxygen levels.

Surgical correction:

The standard treatment is the arterial switch operation, usually performed within the first week or two of life.

• In this surgery, the great arteries are placed back in their correct positions, and the coronary arteries are reattached.
• This is a complex operation, but outcomes have improved dramatically. Most children recover well and will only need regular follow-ups with a cardiologist as they grow.

Final Thoughts 

As a parent, hearing that your baby needs heart surgery is never easy. But TGA is a condition doctors understand well, and the tools available today — including early screening and AI-supported imaging — mean that babies can get help quickly and effectively.

If your child has been diagnosed with TGA, know that you're not alone. Connect with heart charities, support groups, and your medical team. Ask every question, and take one step at a time. There is life and joy after TGA. With the right care, your little one has every chance to thrive.

FAQs

Can TGA be detected before birth?

Yes, TGA can often be detected during pregnancy through a detailed foetal ultrasound or foetal echocardiogram.

Is TGA a life-threatening condition if left untreated?

Yes, without treatment, TGA is life-threatening due to the lack of oxygen-rich blood reaching the body.

What is the survival rate after TGA surgery?

The survival rate after TGA surgery is over 95% in centres with experienced paediatric heart surgeons.

Can a baby with TGA lead a normal life after treatment?

Yes, most children go on to live healthy, active lives after successful surgery and regular follow-ups.

Is TGA linked to genetic disorders or syndromes?

TGA is usually not linked to genetic syndromes, but in some cases, it may occur alongside other genetic or chromosomal conditions.