Pulmonary venous baffle obstruction following senning procedure - Role of transesophageal echocardiography

Abstract

We present a case of D-transposition of great arteries with atrial septal defect and patent ductus arteriosus electively posted for Senning's operation at 10 months of age. The patient developed signs of lung congestion immediately after termination of cardiopulmonary bypass. A stenosis in the pulmonary venous baffle was detected in transesophageal echocardiography showing a peak gradient of 10 mmHg and a mean gradient of 5 mmHg. Hence, revision of baffle was planned. The stenotic area was excised and augmented with homologous pericardium. Post-correction, lung compliance improved and the peak and mean gradient decreased to 3 and 1 mm Hg, respectively. The patient was extubated in the intensive care unit after 36 h and shifted to ward after 5 days with stable hemodynamics.

Hemodynamic Assessment of Structural Heart Disease Using 4D Flow MRI: How We Do It

“…9). Unlike arterial stenoses with an upstream pumping chamber, venous stenoses can be hemodynamically significant with pressure gradients in the range of 5-10 mmHg [34,35]. Venous narrowing should be measured not only for its length and caliber, but when assessed with 4D Flow MRI, also assessed for its hemodynamic severity.…”