What are the problems if TGA is left untreated ?

By now it must be clear to you that TGA is a condition that is not compatible with survival. Unless treated, over 90% of patients will not live to see their first birthday.
There are a few exceptional circumstances.
First is the child with TGA and a large VSD. "Mixing" of blood from both sides of the heart takes place across the VSD. So there is enough oxygen supplied to the different organs to permit adequate, though not normal, function. These children will develop symptoms at a later age. Although there is some oxygen supply, it is not enough for active play or work. The child with TGA and VSD will tire easily during any prolonged activity. Giddiness and fainting spells may occur. In addition there are problems related to the VSD. These include frequent chest infections, breathlessness and in long standing cases, development of high pressure and wall thickening in the blood vessels of the lung - Pulmonary Hypertension.
And then there is the extremely fortunate combination of TGA with VSD along with narrowing of the pulmonary valve - Pulmonary Stenosis. These patients have all the benefits of a TGA with VSD, with one added advantage. The pulmonary valve which guards blood flow into the lungs is narrow. This prevents too much blood entering the lungs, and avoids chest infection, breathlessness, and most important, the later development of pulmonary hypertension. These patients sometimes survive into their 20's and 30's without treatment.

When should TGA be treated ?

The answer in most cases is "AT BIRTH". There are many reasons for this. Most cases of TGA will not survive without immediate prostaglandin therapy. The results of operation are best when performed early. And suitability for different types of operation vary as the child becomes older.

What are the treatment options ?

 

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