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Related Experiment Videos

The double switch operation with accent on the Senning component.

Roger B B Mee1

  • 1The Cleveland Clinic Foundation, OH 44195, USA.

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
|April 9, 2005
PubMed
Summary

Congenitally corrected transposition (ccTGA) presents unique challenges for the systemic ventricle. This article details the inflow switch technique, combining the Senning operation with arterial switch, to reroute the morphologic left ventricle to the systemic circulation.

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Management of the failing systemic right ventricle.

Seminars in thoracic and cardiovascular surgery·2005

Area of Science:

  • Cardiology
  • Congenital Heart Surgery
  • Pediatric Cardiac Surgery

Background:

  • Congenitally corrected transposition (ccTGA) involves complex cardiac anatomy, with the morphologic right ventricle (mRV) acting as the systemic ventricle.
  • The mRV is susceptible to premature failure due to factors like tricuspid valve regurgitation and conduction defects.
  • Existing surgical strategies may not fully address the unique anatomical variations in ccTGA.

Purpose of the Study:

  • To describe the technical details of the inflow switch procedure for ccTGA.
  • To provide guidance for congenital heart surgeons with limited experience in inflow switch operations.
  • To present a method for restoring the morphologic left ventricle (mLV) to the systemic circuit in ccTGA.

Main Methods:

  • The article details the author's modified Senning operation combined with an arterial switch procedure.

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  • Techniques are adapted to address anatomical variations in ccTGA, including atrial situs, conduction system, and ventricular looping.
  • Emphasis is placed on modifications necessary for ccTGA compared to typical transposition of the great arteries (TGA).

    • Main Results:

    • The inflow switch procedure was first successfully performed in 1989.
    • The technique aims to redirect the mLV to the systemic circulation, thereby protecting the mRV.
    • The article focuses on the technical aspects and modifications for successful implementation in ccTGA.

    Conclusions:

    • The combined inflow switch and arterial switch operation offers a viable strategy for managing ccTGA.
    • Detailed technical understanding and surgical modifications are crucial for success in ccTGA patients.
    • This approach aims to improve long-term outcomes by preserving the systemic ventricle.