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Transposition of the great arteries (TGA) is a cyanotic congenital heart lesion in which the connection of the aorta and pulmonary artery leaving the heart is reversed such that the right ventricle connects to the aorta and left ventricle to the pulmonary artery. Survival after birth is dependent on adequate mixing through the atrial communication and arterial duct.
There has been a significant increase in the prenatal diagnosis of TGA. In the UK, much of this increase can be attributed to the introduction, in 2015, of an additional transverse view of the upper mediastinum, the three vessel and tracheal view, into the national screening programme at the 20-week anomaly scan.1
Despite the significant rise in the prenatal diagnosis of this condition and improved understanding of features that may increase the risk of restrictive atrial communication in the newborn, predicting the need for emergency septostomy by fetal echocardiography remains imperfect.2 It is well recognised that a small proportion of babies will present with poor mixing …
Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.