What’s Great Vessel Transposition?

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Transposition of the great vessels (TGV) is a congenital heart defect that involves the misplacement of the primary blood vessels of the heart. In cases where the pulmonary artery and aorta become interchanged, the condition may be referred to as transposition of the great arteries (TGA). In other cases, the blood vessels involved may be the pulmonary artery and veins: the superior and inferior vena cava and the aorta. Congenital heart defects, such as TGV, are known as cyanotic defects due to the fact that they cause poor circulation of oxygen in the blood.

There are two main categories of the defect, known as levo- and dextro-transposition of the great vessels. Dextrotransposition of the great vessels involves the literal exchange of two or more primary blood vessels. In cases where both arteries and ventricles interchange, the term levotransposition of the great vessels may be used. The generic term TGV generally refers to all cases in which there is spatial misalignment of the primary blood vessels of the heart, whether or not two vessels are actually interchanged with each other.

In addition to the two main categories of TGV, there are further simple and complex transposition categorizations of large vessels. TGV is often accompanied by other associated heart defects and in these cases may be known as complex transposition of the great vessels. In situations where it occurs on its own, it may be known as simple great vessel transposition.

Like other birth defects, TGV is a condition that affects the developing fetus and can usually be diagnosed before or at the time of birth. A fetal echocardiogram can often detect TGV in the womb, so preparations can be made in advance to properly care for the baby. If not diagnosed before birth, TGV can be diagnosed via a chest X-ray, by checking the blood oxygen level, or in many other ways. Chest X-rays may be effective because of the characteristic shape of the heart in many cases of TGV, while low oxygen is associated with the defect due to blood not being adequately oxygenated before being returned to the body by the heart. If caught early, many hospitals are able to perform a surgery known as an arterial switch to correct the defect.

There are several possible complications that can potentially lead to a fetus developing some form of TGV. Some of these include the mother contracting certain viruses during pregnancy, such as rubella or German measles, or developing gestational diabetes. Furthermore, the risk of TGV may be increased in cases where the mother has pre-existing diabetes or suffers from poor prenatal nutrition.

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