Successful Percutaneous Treatment of Stenosed Mustard Atrial Switch Associated With Superior Vena Cava Baffle Thrombi

Baffle stenosis and thrombus formation are recognized complications of atrial switch operation (ASO), with no concurrent cases documented. A 23-year-old man with dextro-transposition of the great arteries who had previously undergone Mustard ASO presented with progressive dyspnea, peripheral edema, and abdominal distension. Cardiac computed tomography (CT) showed severe bicaval baffle stenosis and 2 superior vena cava baffle thrombi, one occluding the stenosed segment. Mechanical thrombus fragmentation, systemic thrombolysis, and sequential stent implantation in both baffles achieved complete recovery. Follow-up cardiac CT confirmed patency of the stent and the absence of thrombi. The patient was discharged symptom free and on a daily regimen of acenocoumarin, with close follow-up. This case report emphasizes the value of cardiac CT in assessing baffle-related complications and guiding precise interventional strategies. In patients with a history of ASO and baffle complications, percutaneous stenting provides an effective alternative to surgical intervention.