Transposition of the great vessels medical therapy

Transposition of the great vessels Microchapters
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Dextro-transposition of the great arteries
L-transposition of the great arteries
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Kristin Feeney, B.S. [5]

Overview

Surgery is the mainstay of treatment for TGA. However, infusion of PGE1 to a newborn diagnosed with TGA is recommended as it prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.

Medical Therapy

Surgery is the mainstay of treatment for TGA. However, infusion of PGE1 to a newborn diagnosed with TGA is recommended as it prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.

• Prostaglandins (PGE)
  • Prevents the ductus arteriosus from closing, therefore providing an additional shunt through which to provide the systemic circulation with a higher level of oxygen.
• Antibiotics
  • Antibiotics may be administered preventively. However, due to the physical strain caused by uncorrected d-TGA, as well as the potential for introduction of bacteria via arterial and central lines, infection is not uncommon in pre-operative patients.
• Diuretics
  • Diuretics aid in flushing excess fluid from the body, thereby easing strain on the heart.
• Analgesics
  • Analgesics normally are not used pre-operatively, but they may be used in certain cases. They are occasionally used partially for their sedative effects.
• Cardiac glycosides
  • Cardiac glycosides are used to maintain proper heart rhythm while increasing the strength of each contraction.
• Sedatives
  • Sedatives may be used palliatively to prevent a young child from thrashing about or pulling out any of their lines.