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Transposition of the Great Arteries

  • Transposition of the Great Arteries (TGA) results in the aorta emerging from the right ventricle and the pulmonary artery emerging from the left ventricle. The catastrophic consequence of TGA is that the pulmonary and systemic circulation are rendered completely independent circuits. During fetal development communication between these circuits via the ductus arteriosus and the foramen ovale allows successful circulation of oxygenated blood. However, closure of these communication points following delivery is clearly incompatible with life and only those neonates survive who possess a Patent Ductus Arteriosus or Patent Foramen Ovale. Neonates who do survive delivery are highly cyanotic and hypoxemic. Treatment requires maintenance of the patent ductus arteriosus with exogenous administration of PGE2 until surgical intervention can be attempted.