Communicating hydrocephalus secondary to venous complications following intraatrial baffle operation (mustard procedure) for d-Transposition of the great arteries

A 39-month-old male had macrocephaly and communicating hydrocephalus secondary to superior vena cava (SVC) obstruction which was a postoperative complication of an intraatrial baffle operation (Mustard procedure) performed at age 10 months. Computerized tomography revealed progressive hydrocephalus. Cardiac catheterization showed an SVC pressure of 24 mm Hg. IVC and systemic vein atrium pressures were 5 mm Hg. Cineangiograms showed huge azygos collaterals from SVC to IVC. The operation was revised using a Dacron baffle instead of the original pericardial baffle. Nine months postoperatively, the head circumference was 55.0 cm and there was no clinical evidence of SVC obstruction.