TEE is also useful in certain patients to guide interventional procedures or evaluate valve anatomy when transthoracic imaging is challenging, or when infectious endocarditis is suspected [12]. Variant 2: Child or adult. Transposition of the great arteries after atrial switch. Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography. Next imaging study. Transposition of the great arteries (TGA) is a cardiac congenital defect characterized by discordant ventriculoarterial connections, in which the aorta arises above the morphological RV, and the pulmonary artery arises above the morphological LV. In TGA, the aorta usually is anterior to the PA, but it can be beside or behind the PA. The prevalence of TGA is 4.7 per 10,000 live births [19]. TGA accounts for 3% of all CHD and 20% of cyanotic heart disease. There are 2 major types of surgery performed for D-TGA: the atrial switch procedures (Mustard and Senning procedures) and the arterial switch procedures (Jatene procedure). In the atrial switch procedure, intra- atrial venous baffles redirect the systemic and pulmonary venous blood returns to the appropriate atria restoring circulating blood flow. These baffles are created by either using in situ tissue from the right atrial wall and interatrial septum (Senning procedure) or with autologous or synthetic material (Mustard procedure). Ventriculoseptal defects, if present, are also closed. Patients with Mustard or Senning type repair are now typically adult patients. The most common complications following the atrial switch procedures are intra-atrial venous baffle stenoses and leaks. Baffle stenoses typically occur at the superior limb of the baffle where the superior vena cava meets the right atrium. Baffle obstructions and leaks are estimated to occur in approximately 25% of patients [20]. The most important and relatively common postoperative complication is hypertrophy and decreased function of the systemic RV.
Congenital or Acquired Heart Disease. TEE is also useful in certain patients to guide interventional procedures or evaluate valve anatomy when transthoracic imaging is challenging, or when infectious endocarditis is suspected [12]. Variant 2: Child or adult. Transposition of the great arteries after atrial switch. Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography. Next imaging study. Transposition of the great arteries (TGA) is a cardiac congenital defect characterized by discordant ventriculoarterial connections, in which the aorta arises above the morphological RV, and the pulmonary artery arises above the morphological LV. In TGA, the aorta usually is anterior to the PA, but it can be beside or behind the PA. The prevalence of TGA is 4.7 per 10,000 live births [19]. TGA accounts for 3% of all CHD and 20% of cyanotic heart disease. There are 2 major types of surgery performed for D-TGA: the atrial switch procedures (Mustard and Senning procedures) and the arterial switch procedures (Jatene procedure). In the atrial switch procedure, intra- atrial venous baffles redirect the systemic and pulmonary venous blood returns to the appropriate atria restoring circulating blood flow. These baffles are created by either using in situ tissue from the right atrial wall and interatrial septum (Senning procedure) or with autologous or synthetic material (Mustard procedure). Ventriculoseptal defects, if present, are also closed. Patients with Mustard or Senning type repair are now typically adult patients. The most common complications following the atrial switch procedures are intra-atrial venous baffle stenoses and leaks. Baffle stenoses typically occur at the superior limb of the baffle where the superior vena cava meets the right atrium. Baffle obstructions and leaks are estimated to occur in approximately 25% of patients [20]. The most important and relatively common postoperative complication is hypertrophy and decreased function of the systemic RV.