Arterial Switch Surgery (Arterial Switch Operation) in India

Transposition of the great arteries (TGA) is a congenital heart defect in which the two major arteries leaving the heart, the aorta and the pulmonary artery, are reversed. Instead of the aorta carrying oxygen-rich blood from the left ventricle to the body, it arises from the right ventricle, sending oxygen-poor blood to the body while oxygen-rich blood is sent back to the lungs. This creates two separate, disconnected circulations and leaves the baby severely short of oxygen shortly after birth.

The arterial switch operation

The arterial switch operation, also known as the Jatene procedure, surgically repositions the aorta and pulmonary artery back to their correct anatomical connections, and reattaches the coronary arteries to the newly positioned aorta. This restores normal circulation, with oxygen-rich blood flowing to the body and oxygen-poor blood flowing to the lungs, as in a normally formed heart. It is considered the gold-standard, definitive repair for TGA.

Why this surgery is urgent

TGA is not something that can wait. Without surgical correction, a newborn with TGA cannot survive long, as the two circulations do not adequately mix oxygen into the body's blood supply on their own. Before surgery, doctors often use medication (prostaglandin) to keep a natural connection between the two circulations open, or perform a balloon atrial septostomy, a catheter procedure that creates or enlarges an opening between the heart's chambers, to stabilise the baby until the arterial switch operation can be performed, usually within the first one to two weeks of life.

What decides the surgical plan

Most babies with straightforward (simple) TGA go directly to arterial switch surgery. Where TGA occurs alongside other defects, such as a ventricular septal defect, or where the coronary artery pattern is more complex, the surgical approach is adapted accordingly, though the underlying arterial switch principle remains the same. Your paediatric cardiac surgeon confirms the exact plan after reviewing your baby's echocardiogram.