Early outcome in prenatally diagnosed d-TGA is primarily determined by effective intercirculatory mixing and coronary artery anatomy, with an overall postnatal survival rate of 88.8%.
The overall postnatal survival rate for prenatally diagnosed d-TGA was 88.8%.
Coronary artery anomalies were significantly more frequent among non-survivors compared to survivors.
Balloon atrial septostomy (BAS) was performed in a minority of cases and was required in neonates with restrictive interatrial communication.
The study cohort consisted of 116 neonates with postnatally confirmed d-TGA, with a slight male predominance.
Perinatal management of prenatally diagnosed d-TGA included planned delivery at a tertiary center, prostaglandin E1 infusion, and arterial switch operation (ASO).
Early postnatal outcome in d-TGA is primarily determined by effective intercirculatory mixing and coronary artery anatomy.
This research examined outcomes for babies diagnosed before birth with a serious heart condition called transposition of the great arteries (d-TGA), where the two main blood vessels leaving the heart are switched from their normal positions. The study followed 116 babies diagnosed prenatally at a specialized center over 10 years (2015–2024), tracking what happened after birth, including surgeries, complications, and survival. The overall survival rate was high at nearly 89%, suggesting that prenatal detection and delivery at a well-equipped center with immediate medical support can lead to good outcomes for most affected babies. The study found that two key factors determined whether babies survived: whether blood could mix adequately between the heart's two circuits before surgery, and whether the babies had abnormal coronary arteries (the vessels that supply blood to the heart muscle itself). Babies with abnormal coronary arteries were about 11 times more likely to die than those without such anomalies, and coronary artery problems were found in nearly a third of babies who did not survive, compared to only 5% of those who did. Some babies needed an emergency procedure called balloon atrial septostomy to improve blood mixing before their main heart surgery could be performed. This research suggests that knowing about d-TGA before birth is valuable because it allows medical teams to plan delivery at specialized hospitals where immediate treatment — including a medication to keep a critical blood vessel open and prompt surgical repair — can begin right away. It also highlights that abnormal coronary artery anatomy is the most important risk factor for death in these babies, which may help guide counseling for families and prioritization of care after birth.
Ozdemir O, Bornaun H, Guzeltas A, Acar Sirinoglu H, Ozdemir I. (2026). What determines survival in transposition of the great arteries? Insights from a 10-year cohort of prenatally diagnosed cases.. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. https://doi.org/10.1080/14767058.2026.2722568