d-TGA with atrial switch

Case contributed by Azza Elgendy

Presentation

Cyanosis at time of birth. Now the patient is status post remote atrial switch operation.

Patient Data

Age: 40 years
Gender: Male
mri

The aorta arises from the morphologic right ventricle, the main pulmonary artery arises from the morphologic left ventricle. The two systemic veins drains into the left atrium, status post atrial switch and creation of atrial baffle. The four pulmonary veins drain into the right atrium. 

Case Discussion

This is a case of surgically corrected d-TGA, status post atrial switch procedure (Senning repair). The key feature is to identify the right ventricle based on the presence of the moderator band, and the reversed relation of the aorta and pulmonary arteries The aorta lies anterior and to the right side compared to the main pulmonary artery. The atrial switch surgical procedure only switch the two atria by establishing a baffle - or conduit - within the atria that reroutes the deoxygenated blood coming from the inferior and superior cavae to the mitral valve and therefore to the pulmonary circulation. The left ventricle gives off the main pulmonary artery and the right ventricle gives off the aorta. 

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