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]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]

Overview

• Prostaglandin (PGE)
• Antibiotics
• Diuretics
• Analgesics
• Cardiac glycosides
• Sedatives

When PGE is administered to a newborn, 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.

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 aid in flushing excess fluid from the body, thereby easing strain on the heart.

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 are used to maintain proper heart rhythm while increasing the strength of each contraction.

Sedatives may be used palliatively to prevent a young child from thrashing about or pulling out any of their lines.

ACC/AHA Guidelines - Recommendations for Evaluation and Follow-Up of Patients With Congenitally Corrected Transposition of the Great Arteries

Class I

"1. All patients with CCTGA should have a regular follow-up with a cardiologist who has expertise in ACHD. (Level of Evidence: C) "

"2. Echocardiography-Doppler study and/or MRI should be performed yearly or at least every other near by staff trained in imaging complex CHD. (Level of Evidence: C) "