title: Utility of intracardiac echocardiography for atrial baffle leak closure in repaired transposition of the great arteries.
abstract: A 27-year-old male with dextro-transposition of great arteries had Senning atrial switch repair in childhood and dual-chamber pacemaker placement for sinus node dysfunction in adulthood. Transthoracic echocardiography showed a lead in the systemic (anatomic right) ventricle. Multidetector computed tomography showed the lead perforating the baffle in the region of the body of the systemic venous atrium into the systemic ventricle. The lead was extracted, and a new lead was placed in the pulmonary (anatomic left) ventricle. A bidirectional baffle shunt persisted. The iatrogenic baffle leak was percutaneously closed with an Amplatzer septal occluder device using both intracardiac echocardiography (ICE) and three-dimensional transesophageal echocardiography (3D-TEE). We report the first use of ICE for baffle leak closure, which provided a good definition of the complex anatomy and guided the procedure.
authors.affiliation: Division of Cardiology, University of Utah, Salt Lake City, UT, USA. sumankuppahally@hsc.utah.edu
authors.forename: Suman S
authors.initials: SS
authors.lastname: Kuppahally
authors.forename: Sheldon E
authors.initials: SE
authors.lastname: Litwin
authors.forename: Larry S
authors.initials: LS
authors.lastname: Green
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Ishihara
authors.forename: Roger A
authors.initials: RA
authors.lastname: Freedman
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Michaels
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D008297:Male; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014188:Transposition of Great Vessels / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome