Curriculum · Pediatric / Nutrition & Growth / EPI / Routine Child Examination
Transposition of the great arteries
What it is
In transposition of the great arteries the aorta is connected to the right ventricle and the pulmonary artery is connected to the left ventricle. It is the most common cyanotic lesion to present in the newborn period, and it is duct dependent: mixing happens through a PDA, an ASD or a VSD.
How it presents
It is usually detected prenatally on US. Otherwise cyanosis is direct, or comes on day 2 of life when ductal closure leads to a marked reduction in mixing of the desaturated and saturated blood. A single S2 is typically present. Children with transposition and a large VSD have improved intracardiac mixing and less cyanosis, and may instead present with signs of heart failure.