Adult

Transposition of the Great Arteries – Arterial Switch

Transposition of the great arteries is a serious heart condition in which the two main arteries arising from the heart are connected to the heart the wrong way round. Babies born with transposition of the great arteries will become blue shortly after birth and without heart surgery, the condition is usually fatal in the first year of life.

Treatment as a child
You have had an operation called an ‘Arterial Switch’, to switch the arteries back to the correct place in the heart. The coronary arteries, which feed blood to the heart muscle, have to be re-connected. Although this operation is often referred to as “corrective” surgery, it never makes the heart completely normal. The switch is usually done within the first three weeks after birth.

Issues relating to adult patients
The switch operation has been performed for about 20 years now and we know that most patients survive into adult life. Although we are optimistic that life expectancy might be close to normal in many patients who have had a switch procedure, we will not know that for certain until another 50 years or so have gone by. It is therefore very important that you are seen on a regular basis by an Adult Congenital Cardiologist, who can monitor your progress and observe for potential problems: These include

Narrowings near the pulmonary valve (main valve to the lungs)
Impaired function of the left pumping chamber, if there was some damage during the operation
Problems relating to the coronary arteries (these are the arteries that supply blood to the heart)

General advice for the future
Most patients lead a normal active life after a switch operation, including sports. If there are any particularly strenuous activities to be avoided your cardiologist will tell you.

All patients who have had a switch operation are at risk of infection in the heart (called endocarditis) after surgery. Such infections may be caused by infections of the teeth or gums, therefore it is important to visit the dentist regularly. You no longer require antibiotic cover with dental treatment. Body piercing and tattoos are best avoided as they also carry a small risk of infection which may spread to the heart.

Because there may be a risk of early disease in the coronary arteries, we strongly advise against smoking.
If you are thinking about starting a family, talk to your cardiologist prior to getting pregnant. We may want to some more tests to assess your heart function.

Adult Congenital Heart Team
Leeds General Infirmary
January 2008 – Reviewed April 2014