Cryoablation of the Slow Atrioventricular Nodal Pathway via a Transbaffle Approach in a Patient with the Mustard Procedure for d-Transposition of the Great Arteries

The ablation of atrioventricular (AV) nodal reentrant tachycardia in patients with the Senning or Mustard procedure is quite challenging because these atrial baffle procedures isolate the AV node from systemic venous access. Cryoablation is commonly utilized for AV nodal slow pathway modification in patients with structurally normal hearts. The cryoablation technique offers the advantage of monitoring AV nodal conduction during lesions, with the ability to terminate a lesion prior to permanent injury to the AV node. This case describes the successful cryoablation of the slow AV nodal pathway via the transbaffle approach in a patient with d-transposition of the great arteries status post the Mustard procedure.