Three‐Dimensional Image of a Baffle Leak in a Patient with a Mustard Operation

Abstract

Mini‐Abstract Baffle leaks are one type of complication following the Mustard operation for transposition of the great arteries. In this case, a 27‐year‐old male status post–Mustard operation scheduled for a pacemaker placement was noted to have a positive agitated saline contrast study via transesophageal echocardiography. The baffle leak could not be well defined despite extensive two‐dimensional imaging. With three‐dimensional imaging, the superior and posterior located baffle leak was clearly imaged. Three‐dimensional echocardiography allows unparalleled imaging in identifying the location of baffle leaks in patients with complex intracardiac procedures such as the Mustard operation.

Guidelines for Performing a Comprehensive Transesophageal Echocardiographic

“…Imaging of the entire baffle requires 3D full-volume acquisition and cropping. [205][206][207] Key Points Role of TEE in Fontan Assessment. Stage 3 reconstruction, the Fontan operation, directs IVC flow to the pulmonary circulation using an intracardiac lateral tunnel or an extracardiac conduit, although there are still some atrio-pulmonary connections in the ACHD population.…”

Real-time three-dimensional trans-oesophageal echocardiography-guided balloon dilation of pulmonary venous pathway obstruction in a patient with dextro-transposition of the great arteries after atrial switch surgery: a case report

“…In previous reports, the use of real-time 3D-TOE for the assessment of dextro-transposition of the great arteries, such as baffle leak or systemic venous obstruction, has been demonstrated. 6,7 In general, when dealing with baffle obstruction after a Mustard procedure, interventional cardiologists usually use fluoroscopy or intra-cardiac echocardiography not equipped with a threedimensional function. Compared to the conventional twodimensional image, our three-dimensional image revealed the characteristics of the stenosis in the pulmonary venous atrium more precisely, which could be easily dilated with balloon.…”

Accuracy of Imaging Modalities in Detection of Baffle Leaks in Patients Following Atrial Switch Operation

“…Also, only patients that underwent a catheterization were reviewed for this study, so further selection bias cannot be ruled out. Finally, other imaging modalities such as intracardiac echocardiography, three‐dimensional TTE, and three‐dimensional TEE were not evaluated in this study so no comment can be made about their sensitivity and specificity . However, as three‐dimensional imaging is highly dependent on the two‐dimensional images obtained, it is likely the sensitivity and specificity of this imaging modality would be similar to the standard two‐dimensional imaging results.…”