Modified Senning procedure for the correction of the transposition of the great arteries: Mid-term results

Background

Many patients with Transposition of the great arteries (TGA) who underwent Senning procedure are in follow-up and approaching adulthood. This study aimed to assess the mid-term outcome after Senning procedure to disclose and manage subsequent complications.

Methods

Twenty five d-TGA patients, who underwent Modified Senning Procedure were enrolled in the study. Investigations done included 12- leads ECG and 24 h Holter monitoring for detection of cardiac arrhythmias. Two dimensional Echocardiography and 2-D Doppler ultrasound were done to evaluate the right ventricular function and detect any postoperative complications.

Results

The median age was 6.3 years (mean: 7.25 ± 3.2, range 4–16 years). The median follow-up duration was 5.5 years (mean: 6.04 ± 3.2, range: 1.5–14.6 years). There were no mortalities and no need for reoperations. All patients had good right ventricular function and baffle leaks were present in 12% of the cases. Significant tricuspid regurgitation was encountered in 36% of the patients. Ninety six percent of the patients maintained sinus rhythm. Tachyarrhythmias were present in 3 patients (12%) and one patient (4%) had complete heart block and required pacemaker insertion. Eighty eight percent of the patients were in NYHA class I-II and the event-free survival rate was 100%, 67.8% and 28.6% at 1, 5, and 10 years respectively.

Conclusions

Despite that data from our study revealed satisfactory outcome as regards mortality and functional status of d-TGA children, further studies are warranted to assess the long term outcome of these patients and for further assessment of their right ventricular function.