Transposition of the great vessels natural History, complications & prognosis


 * 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]

Prognosis
The prognosis on simple d-TGA depends mainly on the presence of cardiac shunts such as FO, ASD, VSD, and DA. If one or more of these defects are present, blood will be mixed, allowing a small amount of oxygen to be delivered to the body, giving an opportunity to the newborn to survive long enough to receive corrective surgery.

With complex d-TGA, the infant will fail to thrive and is unlikely to survive longer than a year if corrective surgery is not performed. Generally, if the defect (d-TGA) is not corrected during the first year of life, the patient's condition will deteriorate to the point of inoperability. Modern repair procedures within the ideal timeframe and without additional complications have a very high success rate.

With simple d-TGA, if the foramen ovale and ductus arteriosus are allowed to close naturally, the newborn will likely not survive long enough to receive corrective surgery. With complex d-TGA, the infant will fail to thrive and is unlikely to survive longer than a year if corrective surgery is not performed. In most cases, the patient's condition will deteriorate to the point of inoperability if the defect is not corrected in the first year.

While the foramen ovale and ductus arteriosus are open after birth, some mixing of red and blue blood occurs allowing a small amount of oxygen to be delivered to the body; if ASD, VSD, PFO, and/or PDA are present, this will allow a higher amount of the red and blue blood to be mixed, therefore delivering more oxygen to the body, but can complicate and lengthen the corrective surgery and/or be symptomatic.

Modern repair procedures within the ideal timeframe and without additional complications have a very high success rate.