D-TGA, atrial switch (Senning) procedure and pacemaker

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Congenital heart disease preoperative chest radiograph.

Patient Data

Age: 25 years
Gender: Female
X-ray

Name the congenital heart disease and surgery performed.

The patient has a history of dextro-transposition of the great arteries (d-TGA), with tiny sternotomy sutures placed after a Senning procedure.

There is a 2-lead pacemaker in the left chest wall. The right atrial lead curves posteriorly into the right atrium which has been surgically switched to correct d-TGA. The tight ventricular lead courses through the Senning baffle repair to the left ventricle.

No pneumothorax or pleural effusion. Normal pulmonary vasculature. Normal osseous structures.

Case Discussion

ECG: sinus rhythm and rate, right ventricular hypertrophy (RVH).

Patient has an AAI/DDR mode dual-chamber pacemaker.

Echocardiogram demonstrates the previously-defined anatomy of d-TGA status post-Senning procedure. There is no obstruction seen throughout the baffle. The right ventricular systolic function is fair. The pacemaker leads are seen in the left ventricle. A stent is seen partially in the IVC baffle: see zoomed-in image.

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Case information

rID: 44354
Case created: 18th Apr 2016
Last edited: 29th May 2017
System: Cardiac
Inclusion in quiz mode: Included

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