The atrial switch patient with a dilated subpulmonic left ventricle

In patients with dextro-transposition of the great arteries, the atrial switch procedures reroute the venous inflows and direct them to the opposite ventricles by the creation of intra-atrial baffles. Post atrial switch, baffle leaks or obstructions can occur. Saline contrast echocardiography is the most sensitive means to detect baffle leaks and is routinely performed from an upper extremity peripheral vein. We present a case of a patient with dilated subpulmonic left ventricle, but negative saline contrast study found to have an inferior baffle leak at cardiac catheterization.