Transposition of the Great Vessels is defined by which arrangement?

Transposition of the Great Vessels is defined by which arrangement?

• A. Aorta from left ventricle and pulmonary artery from right ventricle
• B. Both great vessels from right ventricle
• C. Aorta from right ventricle and pulmonary artery from left ventricle
• D. Both from left ventricle

Answer: (D)

In transposition of the great vessels, there is ventriculoarterial discordance: the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. This creates two parallel circulations instead of the normal series arrangement. Deoxygenated blood from the body returns to the right heart and is pumped back into the systemic circulation via the aorta, while oxygenated blood from the lungs is sent back to the body without first circulating through the lungs. Life relies on mixing between the circuits through a shunt such as a patent foramen ovale, PDA, or VSD. Management often includes keeping the ductus arteriosus open with prostaglandins in the neonate and ultimately surgically correcting the anatomy with an arterial switch operation. The scenario where both great vessels arise from the left ventricle describes a different defect (double outlet left ventricle) and is not transposition.

In transposition of the great vessels, there is ventriculoarterial discordance: the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle. This creates two parallel circulations instead of the normal series arrangement. Deoxygenated blood from the body returns to the right heart and is pumped back into the systemic circulation via the aorta, while oxygenated blood from the lungs is sent back to the body without first circulating through the lungs. Life relies on mixing between the circuits through a shunt such as a patent foramen ovale, PDA, or VSD. Management often includes keeping the ductus arteriosus open with prostaglandins in the neonate and ultimately surgically correcting the anatomy with an arterial switch operation. The scenario where both great vessels arise from the left ventricle describes a different defect (double outlet left ventricle) and is not transposition.