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Transposition of the Great Arteries: Grace's Story
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How TGA Develops
Physicians and surgeons explain how a heart affected by TGA doesn’t send oxygenated blood to the body properly.
Transposition of the Great Arteries (TGA) is a severe congenital condition in which the body’s largest arteries are incorrectly attached to the chambers of the heart. In this 23-minute video, you'll learn how experts from the Fetal Heart Program and Cardiac Center identify TGA during pregnancy, support the baby's delivery, and provide surgery and comprehensive care after birth.
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Transcript: How TGA Develops
Jack Rychik, MD: In the normal circulation the two circulations exist the what we call a series where the blue blood, the deoxygenated blood, drains into the right ventricle, makes its way through the lung, then returns to the left side of the heart as oxygenated pink blood, and makes its way to the body.
J. William Gaynor, MD: In transposition the pulmonary artery and the aorta are switched, or transposed, so they come off the opposite pumping chamber. What that means is that the blue blood comes back to the right atrium, to the right ventricle, but now instead of going to the lungs it goes back out to the body. So you have blue blood going in a circle, never picks up oxygen.
Peter Gruber, MD: Oxygenated blood from the lungs then returns to the left side of the heart. Comes from the left side of the heart out to the pulmonary artery, goes to the lungs in a separate circulation.
Jack Rychik, MD: This creates what we call a parallel circulation where blue blood continues to be ejected back to the body and pink blood begins to get ejected back to the lung and the two circulations don't meet.
Thomas Spray, MD: You cannot survive that situation, of course, unless there's some mixing somewhere in the heart. The mixing can occur at three different places. It can occur at the ductus arteriosus, which is the connection from the arteries to the lungs and the body, that's always present at birth but then typically closes because it's programmed to close after birth. Then there can be mixing between the two pumping chambers of the heart if you happen to have a hole there, called the ventricular septal defect. But the best mixing occurs at the upper chamber of the heart called the atrial septum and that can be open or not in these children. So how stable these babies are depends on how much mixing there is at those three levels.
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