The human heart is a wondrous organ. Containing within it the life-force of the living, the heart is usually considered one of the most important, if not the most important, parts of the human body. It is claimed by many in the field of medicine that the heart pumps more than 7500 litres (2000 gallons) of blood per day, i.e. more than 300 litres (above 80 gallons) per hour. The heart has to work a lot to maintain this load of pumping and purifying blood. And so the maintenance of the human heart is also very essential for us to have a healthy living.
What is Transposition of the Great Arteries (TGA)?
Transposition of the great arteries (TGA) is a rare but severe heart disorder that is present at birth (congenital). In this condition, the two main arteries (aorta and pulmonary artery) are improperly connected leaving them in a reversed state of being (transposed). This condition is sometimes also referred to as dextro-transposition or d-transposition of the great arteries.
What is the difference between a normal and a TGA affected heart?
In normal cases, the de-oxygenated blood coming from the body enters the heart through the right atrium and travels to the right ventricle which is then further pumped into the lungs through the pulmonary artery to receive fresh supply of oxygen. This freshly oxygenated blood then returns to the heart through the left atrium from the lungs, travels to the right ventricle which is then pumped throughout the body via the aorta.
TGA affected Heart
But, in the case of transposition of the great arteries (TGA), the pulmonary artery is connected to the left ventricle instead of the right ventricle and the aorta is connected to the right ventricle instead of the left ventricle. This opposite arrangement of the arteries drastically changes the flow of the blood throughout the body. As the de-oxygenated blood and the freshly oxygenated blood from the left and the right ventricle respectively get mixed together, this creates a fatal shortage of oxygen in the blood flowing from the heart to the body. Due to this shortage of oxygen, the organs in the body can’t do their function properly which may lead to the child facing many serious and sometimes mortal complications.
This disorder is usually detectable prenatally or can also be detected after birth; from a few hours to a few weeks, depending on the condition of the newborn. Several different heart defects may also be present in the newborn along with TGA. Some of these heart defects may actually be beneficial and aid in the survival of the baby. Some of these defects of the heart like atrial or ventricular septal defect allow blood from the left and right side of the heart to mix which may turn out to be better for the child as the mixed blood contains some amount of oxygen (because of the freshly oxygenated blood in the right ventricle). This is a better position in infants from TGA as the medium amount of oxygen in the mixed purple blood is better than the de-oxygenated blue blood, which will provide the body with some oxygen for their functions to not grind to a halt.
Preliminary Diagnosis for TGA
When this disorder is diagnosed or even suspected, prostaglandin is used in continuous infusion. It is a medication used to keep the ductus arteriosus open. Doing this allows mixing of the oxygenated and the de-oxygenated blood. This prediction is usually taken on the basis of the appearance of any Transposition of the great arteries symptoms.
Treatment for TGA
Some of the more applicable types of TGA or transposition of the great arteries surgery is:
Atrial Switch Operation
This procedure is considered uncommon. In this surgery, a baffle or tunnel is created between the atria (upper heart chambers) of the heart. This allows the de-oxygenated blood from the right atrium to move to the left ventricle and out towards the lungs through the pulmonary artery. This returns oxygenated blood from the left atrium to the right ventricle and out through the aorta to the rest of the body. Even though this process helps in the blood to flow from the heart to the rest of the body, it also puts extra load on the right ventricle for pumping blood to the rest of the body. Because of this, there may be further difficulties in the future.
Arterial Switch Operation
This is one of the most common procedures in the world and is usually done during the first month of the birth. This is used to restore the regular blood flow of the heart to the rest of the body. The arteries are switched to their normal positions in this procedure. The aorta is adjusted to come out from the left ventricle and the pulmonary artery is adjusted to out from the right ventricle. Movement and reattachment of the coronary arteries also takes place in this treatment.
Balloon Atrial Septostomy (BAS)
This procedure is usually done within a couple of hours after the birth of the infant. In this surgery, a hole is created or enlarged between the atria (upper chambers) of the heart using a special type of catheter with a balloon in the tip which allows the red (freshly oxygenated) and the blue (de-oxygenated) blood to mix.
These treatments have been observed to bring desired effects in typical cases but in some complex cases these methods may not yield any positive result at all. In such cases, an open heart surgery may be required to tackle the situation and give the child relief from the symptoms of the disorder. Even though these procedures are considered effective, they may not work as a complete solution. The patient may have to face lifelong complications relating to the heart.
Why choose India to have your TGA treatment?
India is gaining fame in the world for being the best destination to undergo any medical procedure. As the hospitals in India provide the most advanced of treatments for a plethora of different diseases and disorders and the surgeons in India are famed to have huge experience in their field of medicine, with having done surgeries in countries like Germany, France, USA, UK, Canada and many more. The Transposition of the great arteries cost in India is also considered to be very less when compared to that of the developed countries. The treatment prices in India may linger in the range of 40-60% of the price of the same treatment with advanced technology in contrast to the western nations.
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