The first time I scanned a patient with grown up congenital heart disease I saw something I’d only read about…

d (dextro)-transposition of the great arteries

Transposition of the great vessels from the CDC

The common treatment for this condition is currently an arterial switch operation where possible. This restores the normal situation of the morphological left and right ventricles being the systemic and pulmonary ventricles, respectively. However, historically an atrial switch procedure (Mustard or Senning procedure) was performed, in which baffles are created to redirect blood to the pulmonary or systemic ventricles as required. The problem with this correction is that the morphological right ventricle remains the systemic ventricle, which leads to progressive right (systemic) ventricular failure over decades.

Cover image: Mustard seeds by Mouser NerdBot on Flickr