MRA Chest MRA chest provides important information regarding extracardiac structures such as the branch pulmonary arteries, systemic and pulmonary veins, and superior and inferior limb baffles and is used in conjunction with CMR for morphology and function to provide comprehensive evaluation of the cardiovascular system after treatment for TGA. MRA Neck There is no relevant literature to support the use of MRA neck in the evaluation of TGA after atrial switch. MRI Heart Function and Morphology CMR yields accurate and reproducible data regarding ventricular size and function, especially follow-up of systemic RV status and intracardiac baffles. MRI Heart Function with Stress CMR is a the most useful imaging modality to screen for myocardial ischemia, but this is uncommon after atrial switch for TGA because the coronary arteries are not manipulated during surgery. Radiography Chest Radiography of the chest can be used for preliminary assessment of stent position, pacemaker generator and lead position, and as needed during the course of follow-up. SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of single-photon emission CT (SPECT)/CT myocardial perfusion imaging (MPI) rest and stress in the evaluation of TGA after atrial switch. US Echocardiography Transesophageal TEE is useful in patients with poor transthoracic acoustic windows, during intraoperative imaging, and in patients (usually adolescents) who require cardioversion for arrhythmia. It is typically used to assess the adequacy of intraoperative repair TTE and may be more sensitive to detect baffle leaks and baffle obstruction. TEE is also helpful to guide catheter-based treatment of pathway obstruction such as balloon dilation, stent placement, or device closure of baffle leaks. Variant 3: Child or adult. Transposition of the great arteries after arterial switch. Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography.
Congenital or Acquired Heart Disease. MRA Chest MRA chest provides important information regarding extracardiac structures such as the branch pulmonary arteries, systemic and pulmonary veins, and superior and inferior limb baffles and is used in conjunction with CMR for morphology and function to provide comprehensive evaluation of the cardiovascular system after treatment for TGA. MRA Neck There is no relevant literature to support the use of MRA neck in the evaluation of TGA after atrial switch. MRI Heart Function and Morphology CMR yields accurate and reproducible data regarding ventricular size and function, especially follow-up of systemic RV status and intracardiac baffles. MRI Heart Function with Stress CMR is a the most useful imaging modality to screen for myocardial ischemia, but this is uncommon after atrial switch for TGA because the coronary arteries are not manipulated during surgery. Radiography Chest Radiography of the chest can be used for preliminary assessment of stent position, pacemaker generator and lead position, and as needed during the course of follow-up. SPECT or SPECT/CT MPI Rest and Stress There is no relevant literature to support the use of single-photon emission CT (SPECT)/CT myocardial perfusion imaging (MPI) rest and stress in the evaluation of TGA after atrial switch. US Echocardiography Transesophageal TEE is useful in patients with poor transthoracic acoustic windows, during intraoperative imaging, and in patients (usually adolescents) who require cardioversion for arrhythmia. It is typically used to assess the adequacy of intraoperative repair TTE and may be more sensitive to detect baffle leaks and baffle obstruction. TEE is also helpful to guide catheter-based treatment of pathway obstruction such as balloon dilation, stent placement, or device closure of baffle leaks. Variant 3: Child or adult. Transposition of the great arteries after arterial switch. Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography.