Introduction : In the current era, the Arterial Switch Operation (ASO) is the preferred surgical procedure offered (usually within the first month of life) to babies born with isolated Transposition of the Great Arteries (TGA). Atrial repair still has merit to deal with the older patient with deconditioned Left Ventricle (LV) or other anatomic features making an ASO less attractive.
Materials and methods : We reviewed the in hospital charts of 68 consecutive patients with isolated TGA, all referred late from abroad and undergoing a Senning Operation (SO) between 1990 and 2004 at a median age of 6 months (range 25d – 8y). The M/F ratio was 2.4.
Results : In hospital mortality was 1.5 % (1 pt) and 25 pts (37 %) suffered at least one complication, the most frequent of which being transient supraventricular arrhythmia. Seven patients (10 %) had immediate revision for a stenotic Systemic Venous (SV) or Pulmonary Venous (PV) channel. The mean ICU stay was 8 days and the mean intubation time was 2 days. Complications were more frequent before 1994 than after but the need for an immediate revision was not. They were evenly distributed below and above the age of 6 months. Central Venous Pressure (CVP) (> or < 15 mm Hg) was not predictive of a SV pathway restriction. Closure of the Atrial Septum Defect using the inverted Left Atrial Appendage was predictive of immediate PV pathway restriction.
Conclusion : Despite the limitations of this retrospective in hospital study, the SO appears as a safe procedure for isolated TGA after the newborn period with low mortality and morbidity (mostly transient). It remains conceptually and technically demanding. Comfort with its performance is beneficial in anatomic repair of congenitally corrected TGA and other related complex anomalies.