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PRESENTED BY:

L Premeshwori Devi
M.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 like
ASD
VSD
PDA

Prominent and progressive cyanosis within


the first 24 hours of life is the usual finding
in infants.
Tachypnea
Tachycardia
Diaphoresis
Failure to gain weight

History collection
Physical examination
ABG analysis
Echocardiography
Cardiac catheterization

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

Immediate management includes


Establishing 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- Acidosis
Mechanical ventilation

Ballon atrial septostomy.


Arterial switch procedure

Congestive heart failure


Arrhythmia
Eisenmenger syndrome (irreversible and
progressive pulmonary vascular obstructive
disease)

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