CPD Questions (Unbaffling Baffles)

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1. In d-transposition of the great arteries (d-TGA), which of the following anatomical relationships is correct?:

A. Aorta arises from the LV and PA from the RVB. Aorta arises from the RV and PA from the LVC. Both great arteries arise from the LVD. Both great arteries arise from the RVE. The pulmonary arteries arise from the aorta

2. Why is mixing of oxygenated and deoxygenated blood necessary in patients with untreated d-TGA?:

A. To increase coronary perfusionB. To reduce pulmonary vascular resistanceC. To allow survival by enabling systemic oxygen deliveryD. To prevent systemic hypertensionE. To improve ventricular contractility

3. Which procedure is considered the current gold standard surgical correction for simple d-TGA?:

A. Fontan procedureB. Glenn shuntC. Mustard operationD. Senning operationE. Arterial switch operation

4. In the atrial switch operation, systemic venous blood is redirected to which anatomic structure first?:

A. Right ventricleB. AortaC. Left atriumD. Pulmonary veinsE. Coronary sinus

5. Which statement correctly distinguishes the Senning and Mustard procedures?:

A. Senning uses prosthetic material while Mustard uses atrial tissueB. Mustard uses prosthetic/pericardial material while Senning uses native atrial tissueC. Senning involves arterial transectionD. Mustard avoids baffle creationE. Both procedures are easily distinguished on echocardiography

6. Which complication is more commonly associated with the Mustard procedure?:

A. Pulmonary venous baffle obstructionB. Systemic venous baffle obstructionC. Development of pulmonary hypertensionD. Biatrial baffle leaksE. Left (subpulmonary) ventricular systolic dysfunction

7. On spectral Doppler assessment of a baffle following an atrial switch procedure, which finding suggests significant baffle obstruction?:

A. Peak velocity less than 1.0 m/sB. Laminar phasic flow returning to baselineC. Absence of colour flowD. Continuous flow that does not return to baselineE. Biphasic flow pattern

8. What is the main clinical concern associated with small baffle leaks after atrial switch procedures?:

A. Left (subpulmonary) ventricular failureB. Catastrophic rupture of the baffleC. Paradoxical embolus and strokeD. Complete heart blockE. Pulmonary hypertension

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