D-TGA, atrial switch procedure and pacemaker

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Chest radiograph ordered for congestive heart failure and to assess pulmonary vascular status.

Patient Data

Age: 32
Gender: Male
Modality: CT

DTGA, atrial switch procedure.

Where is the right atrial lead going?

Modality: X-ray

The patient has a known history of congenital heart disease: D-TGA and corrective surgery.
Sternotomy wires are noted.

There is a left chest wall 2-lead ICD.

  • the atrial lead crosses to the left of midline and overlies posteriorly in the region of the functional right atrium or anatomical left atrium
  • the ventricular / ICD lead crosses to the left of the midline and is terminating posteriorly, likely in the functional posterior right ventricle which is anatomical left ventricle.

Lungs are clear. No pneumothorax or pleural effusion.
 

Case Discussion

In atrial baffle surgeries with D-TGA radiologists should recognise the aberrant course of the pacemaker/ICD leads.

PlayAdd to Share

Case Information

rID: 39434
Case created: 3rd Sep 2015
Last edited: 18th Sep 2016
Systems: Cardiac, Chest
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.