Article

lock Open Access lock Peer-Reviewed

1

Views

CASE REPORT

Surgical correction for atrial inversion in Senning operation in case of right ventricular dysfunction

Adib D Jatene; Fábio B Jatene; Marcelo B Jatene; N Ikari; Deipara M. A Machado

DOI: 10.1590/S0102-76381991000100009

ABSTRACT

A new proposal for the treatment of right ventricular dysfunction in late postoperative period of patients submitted to Senning operation is presented. The technique could be used in cases originally with transposition of the great arteries associated with pulmonary stenosis and a large VSD. A 12-year-old patient, who had been submitted, 8 years before, to an atrial inversion associated with closure of a large VSD and relieve of a pulmonary stonosis was submitted to this new operation. Senning operation was undone thus reestablishing atrio-ventricular concordance; the patch used for closure of VSD was removed, and the aorta was connected to the left-ventricle. Pulmonary artery was cut transversally, adjacent to the valvar horizontal plane. The proximal extremity was sutured and the distal was connected to the right ventricle through a valvar tube graft of bovine pericardium. The clinical course was uneventful and the patient improved from functional class IV to I/II.

RESUMO

Os autores apresentam uma nova proposta para tratar disfunção do ventrículo direito no pós-operatório tardio da transposição das grandes artérias associada a grande comunicação interventricular e que tenha sido tratada pela inversão em nível atrial. Apresentam o caso de um paciente com 12 anos de idade, que havia sido submetido a operação de Senning associada a fechamento de comunicação interventricular e alivio de estenose pulmonar há 8 anos. A operação de Senning foi desfeita, restabelecendo-se a concordância atrioventricular, o remendo que fechava a comunicação interventricular foi ressecado, conectando-se a aorta com o ventrículo esquerdo. A artéria pulmonar foi seccionada transversalmente, próximo ao plano valvar. O coto proximal foi suturado e o distai, conectado ao ventrículo direito através de tubo valvulado de pericárdio bovino. A evolução foi satisfatória, revertendo-se a situação do paciente do grupo funcional IV para grupo I/II.
Full text available only in portuguese PDF format.

REFERENCES

1. BATTISTESSA, S. & DEVERALL, P. B. - Surgical relief of subpulmonary stenosis after previous Senning (or Mustard) operation for complete transposition. Int. J. Cardiol., 24: 230-233, 1989. [MedLine]

2. CRUPI, G.; PILLAI, R.; PARENZAN, L.; LINCOLN, C. - Surgical treatment of subpulmonary obstruction in transposition of the great arteries by means of a left ventricle pulmonary artery conduit. J. Thorac. Cardiovasc. Surg., 89: 907-913, 1985. [MedLine]

3. JATENE, A. D.; FONTES, V. F.; PAULISTA, P. P.; SOUZA, L. C. B.; NEGER, F.; GALANTIER, M.; SOUSA, J. E. M. R. - Anatomic correction of transposition of the great vessels. J. Thorac. Cardiovasc. Surg., 73: 363-370, 1976.

4. MEE, R. B. B. - Severe right ventricular failure after Mustard or Senning operation. Two-stage repair: pulmonary artery banding and switch. J. Thorac. Cardiovasc. Surg., 92: 385-390, 1986. [MedLine]

5. MUSTARD, W. T. - Successful two-stage correction of transposition of the great vessels. Surgery, 55: 469-472, 1964. [MedLine]

6. RASTELLI, G. C.; WALLACE, R. B.; ONGLWY, P. A. - Complete repair of transposition of the great arteries with pulmonary stenosis: a review and report of a case corrected by using a new surgical technique. Circulation, 39: 83-95, 1969. [MedLine]

7. SAXEMA, A.; FONG, L. V.; OLGILVE, B. C.; KEETON, B. R. - Use of balloon dilatation to tear supravalvar stenosis developing after anatomical correction for complete transposition. Br. Heart J., 64: 151-155, 1990. [MedLine]

8. SENNING, A. - Surgical correction of transposition of the great vessels. Surgery, 45: 966-980, 1959. [MedLine]

CCBY All scientific articles published at bjcvs.org are licensed under a Creative Commons license

Indexes

All rights reserved 2017 / © 2020 Brazilian Society of Cardiovascular Surgery DEVELOPMENT BY