Dextro-transposition of the great arteries classification


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; ; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
Dextro-transposition of the great arteries can be classified into simple and complex based on the other types of defect associated with them.

Classification

 * Simple d-TGA
 * No other associated cardiac defects are present.


 * Complex d-TGA
 * d-TGA is often accompanied by other heart defects, the most common type being intracardiac shunt such as atrial septal defect including patent foramen ovale, ventricular septal defect, and patent ductus arteriosus. Stenosis of heart valves or blood vessels may also be present.
 * An accompanying VSD is present in 40% of these patients.
 * Pulmonary stenosis and a VSD are present in 31% of patients.
 * Although it may seem counterintuitive, complex d-TGA presents better chance of survival and less child developmental risks than simple d-TGA, as well as usually requiring fewer invasive palliative procedures. This is because the left-to-right shunt and bidirectional shunt caused by the defects common to complex d-TGA allow a higher amount of oxygen-rich blood to enter the systemic circulation.
 * However, complex d-TGA may be associated with a slight increase in the length and risk of the corrective surgery, as most or all other heart defects will normally be repaired at the same time.

Acknowledgements and Initial Contributors to Page
Leida Perez, M.D.