介入および一般心臓学ジャーナル

Evolution of Senning Procedure: Mid-term outcome in a single center experience.

Abstract

Ahmed Al-Gebal , Rania Aboushokka , Amal Younan , Hanan Mohammed , Rasha Hossny, Yahia Mahmoud , Mohamed Abdel Hady and Ahmed Zayed

Objectives: Evaluate our midterm outcome after Senning procedure for physiologic repair of Simple Transposition.

Patients and Methods: a retrospective study on patients who were diagnosed as simple Transposition and were not allocated to arterial switch operation. The patients enrolled in the study were operated between 2000 and 2018 and the operative data were obtained from patient’s files and the midterm outcome were obtained from outpatient’s records.

Results: 88 patients were done at this period, of whom only 43 patients were followed as the missing patients either following up in other centers in remote areas or may die and no data available for follow up records. The 43 patients had operated by 2 techniques either the standard Senning (26 patients) or the modified in situ pericardial Senning (17 patients). The 5-year survival in the standard group was 88.5% and 94% In pericardial insitu Senning, P value (0.89).5 years freedom from Arrythmias was 76.9% in Standard Senning and 88.2% in modified in situ pericardial Senning, P value (0.21). 5 years freedom from Significant TR was 69.2% in Standard Senning and 82.3% in modified in situ pericardial Senning, P value (0.73). 5 years freedom from Significant RV dysfunction was 65.3% in Standard Senning and 88.2% in modified in situ pericardial Senning, P value (0.52). There was no significant difference among the studied groups regarding midterm outcome.

Conclusion: In developing countries selection criteria limits the standard anatomical correction of simple Transposition. For those patients who had complex coronary artery anatomy, neonatal medical condition that precludes anatomical repair of simple TGA; the atrial switch still have a role for physiologic repair of simple TGA.