Contemporary imaging following atrial redirection surgery for transposition of the great arteries

A young man attended the adult congenital heart disease clinic for routine follow-up. He had a diagnosis of transposition of the great arteries (TGA) and underwent a Senning procedure at 10 months of age. He had remained well over the intervening years, was fully saturated, with a normal exercise tolerance, no cardiovascular symptoms and no history of arrhythmia or symptoms suggesting thromboembolic events. Transthoracic echocardiogram is shown in figure 1A and cardiac MRI image in figure 1B.

Which of the following is the most likely diagnosis? Intact atrial pathwaysSecundum atrial septal defectBaffle leakPrimum atrial septal defectBaffle obstruction.