October 20, 2021

Learn more about Congenital Corrected Transposition of the Great Arteries

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As a Foundation dealing with heart disorders, when we try to raise CSR support for healthcare, a lot of people are unaware about what we are talking about. This simply happens because people don’t have enough information to make those decisions. Trying to fill in that gap, today we would like to talk about one type of Congenital Heart Defect called Congenital Corrected Transposition of the Great Arteries (CCTGA).

Congenital Corrected Transposition of the Great Arteries



It is a rare complex congenital heart defect in which the heart’s lower half is reversed, and it was was first reported by Dr Rokitansky in 1875.

A normal heart is divided into 2 parts. The right half pumps blood from the body into the lungs for purification. The left side pumps purified blood into the body. Each side of the heart has an atrium and a ventricle. The atrium is like a collection chamber for the blood while the ventricle pumps blood into the lungs or the body. At the entrance and exit of the ventricle there are valves and these valves regulate the flow of blood. Each valve and ventricle has a specific job because the right ventricle pushes blood at a lower force to the lungs while the left ventricle pushes blood at a greater force to the body. The right ventricle is larger than the left ventricle and the Mitral valve between the left atrium and ventricle is the strongest heart valve amongst the 4 valves.

In CCTGA the two ventricles and the respective valves are reversed. The weaker right ventricle grows on the heart’s left side. It pumps pure blood to the body. The stronger left ventricle grows on the heart’s right side pumping impure blood to the lungs.

Incidence

About 0.5% of all children born with Congenital Heart Defects have CCTGA. It affects about 1 in 25,000 live births worldwide.

Presentation

Some babies born with CCTGA have murmurs, heart rhythm issues, while some babies have a Ventricular Septal Defect with CCTGA. In the latter case, the babies are generally cyanotic.

In some instances, the diagnosis is not made until the child grows up as there are no symptoms. With passage of time however there can be heart failure as the right ventricle is pumping pure blood and left ventricle is pumping impure blood. In some cases, CCTGA is found with other defects like Ebstein’s Anomaly, Pulmonary Stenosis etc. 

Treatment

Open heart surgery is the only option to cure CCTGA. A procedure called Double Switch is performed. It is a major surgery in which a switch operation is performed at the Atrium level first and then at the Ventricle level. Hence it is called Double Switch Surgery.

In children where there is Pulmonary Stenosis, a conduit is required, which is placed from the Right Ventricle to the Pulmonary Artery. With new methodology like the Ozaki procedure, heart valves can be recreated using the patient’s own tissues, thereby avoiding the use of conduit. The overall cost is reduced and the recovery is also faster. More ever the chances of a redo surgery in future gets reduced.

Long Term Outcome

The long-term prognosis of Double Switch Surgery for children with CCTGA is good. Some of the children may develop heart blocks or leakage in heart valves with passage of time, thus they must be in constant follow up with a pediatric cardiologist for their own safety.

If you’re interested in CSR support for healthcare, then you can visit the website for Genesis Foundation à genesis-foundation-net and ties up with them to make a difference.