2-DIMENSIONAL AND DOPPLER-ECHOCARDIOGRAPH Y AFTER ATRIAL SWITCH OPERATION FOR TRANSPOSITION OF THE GREAT-ARTERIES

Introduction of the atrial baffle procedure (Mustard, Senning) more th an 30 years ago has dramatically improved the prognosis of patients wi th transposition of the great arteries. However, a range of late compl ications can occur even in clinically asymptomatic patients including: superior and inferior limb obstruction, pulmonary venous obstruction, residual baffle-leakage, left ventricular outflow tract obstruction, tricuspid valve regurgitation, right ventricular dysfunction and posto perative dysrhythmia. As an increasing number of patients has reached adulthood an accurate noninvasive technique is needed for routine foll ow-up studies. In most patients transthoracic two-dimensional (2D) and Doppler echocardiography allows a complete investigation of postopera tive hemodynamic abnormalities - in particular assessment of atrial ba ffle function. In adult patients with restricted echo-windows transoes ophageal echocardiography may provide a more detailed assessment of at rial baffle morphology and function; TEE seems to be superior compared to angiography and magnetic resonance imaging. Furthermore TEE is a r eliable guiding and monitoring technique during interventional cardiac catheterization procedures such as balloon dilatation or stent implan tation and allows further surveillance. Even if compared to other noni nvasive diagnostic procedures, 2D and Doppler echocardiography (transt horacic/transoesophageal) are still the most important and accurate di agnostic methods for routine investigation of the postoperative anatom y and potential late complications in patients who underwent an atrial baffle procedure.