[1] It is called a cyanotic congenital heart defect (CHD) because the newborn infant turns blue from lack of oxygen.

Prenatally, a baby with d-TGA experiences no symptoms as the lungs will not be used until after birth, and oxygen is provided by the mother via the placenta and umbilical cord; in order for the red blood to bypass the lungs in utero, the fetal heart has two shunts that begin to close when the newborn starts breathing; these are the foramen ovale and the ductus arteriosus.

[2] A d-TGA baby will exhibit indrawing beneath the ribcage and "comfortable tachypnea" (rapid breathing); this is likely a homeostatic reflex of the autonomic nervous system in response to hypoxic hypoxia.

[2] If d-TGA is not diagnosed and corrected early on, the infant may eventually experience syncopic episodes and develop clubbing of the fingers and toes.

Differences in the shape of the atrial septum and/or ventricular outflow tracts affect the relative positions of the aorta and pulmonary artery.

This is because the left-to-right and bidirectional shunting caused by the defects common to complex d-TGA allow a higher amount of oxygen-rich blood to enter the systemic circulation.

Angioplasty also requires a balloon catheter, which is used to stretch open a stenotic vessel; this relieves restricted blood flow, which could otherwise lead to congestive heart failure (CHF).

An endovascular stent is sometimes placed in a stenotic vessel immediately following a balloon angioplasty to maintain the widened passage.

Angiography involves using the catheter to release a contrast medium into the chambers and/or vessels of the heart; this process facilitates examining the flow of blood through the chambers during an echocardiogram, or shows the vessels clearly on a chest x-ray, MRI, or CT scan - this is of particular importance, as the coronary arteries must be carefully examined and "mapped out" prior to the corrective surgery.

A pulse oximeter is attached to a finger or toe and provides constant or intermittent monitoring of the blood's oxygen saturation level.

However, due to the physical strain caused by uncorrected d-TGA, as well as the potential for introduction of bacteria via arterial and central lines, infection is not uncommon in pre-operative patients.

In 1984, Nikaidoh introduced a surgical approach for the management of TGA, VSD, and pulmonary stenosis (PS), which he called "aortic translocation and biventricular outflow tract reconstruction".

The repair consisted of harvesting the aortic root from the right ventricle, with or without the coronary arteries attached, and relieving the LVOTO by dividing the outlet septum and pulmonary valve annulus.

The main thing is the repositioning of the native aortic root over to the LV cavity, avoiding the creation of a long tortuous intraventricular tunnel.

The addition of the Lecompte maneuver may prevent branch pulmonary artery stenosis that may occur secondary to compression of the PA by the posteriorly displaced, translocated aortic root.

It creates a direct RV to PA anastomosis and avoiding the use of a conduit, which should decrease the incidence of RVOT reinterventions.

Including the anaesthesia and immediate post operative recovery, this surgery takes an average of approximately six to eight hours to complete.

Following corrective surgery, but prior to cessation of anaesthesia, two small incisions are made immediately below the sternotomy incision which provide exit points for chest tubes used to drain fluid from the thoracic cavity, with one tube placed at the front and another at the rear of the heart.

Additionally, the patient is kept on a cooling blanket for a period of time to prevent fever, which could cause brain damage.

Some patients who had alternate corrective surgery, such as the Mustard or Senning procedure, may have issues with SA and VA nodal transmissions in later life.

This is commonly solved with a Pacemaker unit, providing scar tissue from the original operation does not block its functionality.

With simple d-TGA, if the foramen ovale and ductus arteriosus are allowed to close naturally, the newborn will likely not survive long enough to receive corrective surgery.

With complex d-TGA, the infant will fail to thrive and is unlikely to survive longer than a year if corrective surgery is not performed.

[citation needed] While the foramen ovale and ductus arteriosus are open after birth, some mixing of red and blue blood occurs allowing a small amount of oxygen to be delivered to the body; if ASD, VSD, PFO, and/or PDA are present, this will allow a higher amount of the red and blue blood to be mixed, therefore delivering more oxygen to the body, but can complicate and lengthen the corrective surgery and/or be symptomatic.

[citation needed] Modern repair procedures within the ideal timeframe and without additional complications have a very high success rate.