Abstract
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.