Transposition of the Great Arteries — Arterial Switch
Information for teenagers and adults living with TGA after an arterial switch operation
Transposition of the great arteries (TGA) means the two main arteries leaving the heart were swapped at birth: the aorta came from the right ventricle (so low oxygen blood is being pushed around the body) and the pulmonary artery came from the left ventricle (so high oxygen blood is going back into the lungs again and not supplying the brain and other organs). This is repaired in the newborn period with an arterial switch operation, which reconnects each artery to the correct ventricle.
The arterial switch is now the standard repair, and most people who had it do very well. Lifelong follow-up is still important.
How your circulation works
In the arterial switch, the aorta is reconnected to the left ventricle and the pulmonary artery to the right ventricle, and the coronary arteries (which supply the heart muscle itself) are moved to the new aorta.
After a good repair, blood flows normally: oxygen-poor blood goes to the lungs, and oxygen-rich blood is pumped to the body by the left ventricle.
Long-term, the main things to watch are the coronary arteries (which were moved during surgery), the new aorta (which can widen slightly), and the valves or the connection of the pulmonary artery (which can narrow).
How to stay well
Report chest pain, palpitations or fainting promptly — the coronary arteries were moved during surgery, so any symptom that could suggest reduced blood flow to the heart should be checked quickly.
Keep active. Many people with an arterial switch exercise normally. Before high-level or competitive sport, ask your heart team — they may want to do some checks first.
Take your medicines as prescribed, if you have any.
Avoid smoking and vaping, and keep alcohol sensible.
Pregnancy and procedures: plan them with your ACHD team.
Contact your heart team when you notice any of these:
Chest pain, pressure or tightness — especially with exercise
Palpitations — a racing, fluttering or irregular heartbeat
Fainting or near-fainting
New or worse breathlessness, or feeling unusually tired
Swelling of your ankles, feet or tummy
Emergency — get help immediately if:
If you get sudden chest pain, collapse, or major trouble breathing, call emergency services immediately and tell them you have had an arterial switch operation for transposition of the great arteries.
Your regular check-ups
After an arterial switch, you should be followed up by an ACHD team for life. At your check-ups you will usually have a heart scan (echocardiogram) and an ECG, and often an exercise test and MRI of the heart and aorta. Because the coronary arteries were moved, your team may arrange imaging of the coronary arteries (CT or MRI) — especially before you start high-level exercise or sports.
Questions for your doctor
You may find it helpful to ask your heart team these questions:
Do my coronary arteries need checking, and when?
What level of exercise and sport is safe for me?
Is my new aorta normal, and how often should it be imaged?
What symptoms should I report straight away?
What should I know before dental work, travel or any planned procedure?
ⓘ This leaflet provides general information only and is not medical advice. Always follow the advice of your cardiology team.
