Transposition of the Great Arteries

• Our team of more than 40 pediatric cardiologists has diagnosed and treated this condition in many babies — and we provide any ongoing care children need as they grow into young adults.
• Our pediatric cardiac surgeons perform more than 500 procedures yearly. Each surgeon has deep experience correcting transposed arteries and related heart conditions in newborns and babies early in life.
• We also have a pediatric cardiac anesthesia team and a Cardiac Intensive Care Unit ready to care for children who have heart surgery.
• Your child’s team includes experts from other areas of Seattle Children’s based on their needs, like doctors who specialize in newborns (neonatologists) or lung health (pulmonologists).

• If your developing baby is diagnosed with transposition of the great arteries before birth, our Fetal Care and Treatment Center team works closely with you and your family to plan and prepare for the care your baby will need.
• Your child’s treatment plan is custom-made. We plan and carry out their surgery based on the specific details of their heart defect, like if they have ASD or VSD along with transposed arteries. We closely check your child’s needs to make sure they get the care that is right for them at every age.
• We have a special Adult Congenital Heart Disease Program to meet your child’s long-term healthcare needs. This program, shared with the University of Washington, transitions your child to adult care when they are ready.

• We are committed to your child’s overall health and well-being and to helping your child live a full and active life.
• Whatever types of care your child needs, we will help your family through this experience. We will discuss your child’s condition and treatment options in ways you understand and involve you in every decision.
• Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.
• Seattle Children’s has many resources, from financial to spiritual, to support your child and your family and make the journey as smooth as possible.
• Many children and families travel to Seattle Children’s for heart surgery or other care. We help you coordinate travel and housing so you can stay focused on your child.
• Read more about the supportive care we offer.

• Seattle Children’s takes part in PC4, the Pediatric Cardiac Critical Care Consortium. This is a national group of leaders in treating children with serious heart conditions. PC4 focuses on advancing care by sharing and analyzing data to find what works best.
• With other institutions in PC4, we are studying how long children need a breathing tube and how long they stay in the Cardiac Intensive Care Unit and the hospital after surgery for transposition of the great arteries. The goals are to reduce differences in care between children when it is safe to do so and get more children safely home sooner.

For most babies, surgeons switch the transposed arteries to the correct places in the heart. They connect the pulmonary artery to the right ventricle and the aorta to the left ventricle. The coronary arteries, which bring blood to the heart muscle, also need to be moved so that they stay connected to the aorta. This is called arterial switch surgery. (See our outcomes for arterial switch surgery.)

Some babies need a different surgery based on their body. For example, your baby might need a different surgery if one of their heart valves is small (stenotic) or their coronary arteries are very complex. Some of these other surgeries are called the Mustard, Senning, Rastelli and Nikaidoh procedures (named after the surgeons who developed them). Your baby’s team will talk with you about the surgery your baby needs and why.

Before your baby has surgery, they may need other steps. These may include: 

• Getting medicine (prostaglandin) to keep their ductus arteriosus from closing
• Having cardiac catheterization to enlarge a small hole between the atria that normally closes shortly after birth (patent foramen ovale) using a balloon 

These steps help keep your baby’s condition stable in the days between birth and surgery. This can improve the outcome of surgery.

If your baby has other heart defects, like ASD or VSD, they will typically be repaired during the same surgery.

After surgery, your child will need lifelong follow-up visits with a cardiologist to check that they are doing well and to see whether they need any further treatment.

Children born with complex heart conditions are at risk for problems with the growth and development of their brain and central nervous system. At Seattle Children’s, we have a Cardiac Neurodevelopmental Clinic to assess your child and, if needed, create a plan to help them reach their full potential.