[Congestive heart failure after the Senning operation. Case report]

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Medical Case Reports

Background:

• The Mustard and Senning procedures were standard surgical repairs for d-transposition of the great arteries (d-TGA) from the 1960s to the 1980s.
• These palliative procedures reroute venous blood flow within the atria, aiming to correct the intracardiac mixing of oxygenated and deoxygenated blood in d-TGA.
• While effective in early survival, long-term complications associated with these intra-atrial repairs are increasingly recognized.

Observation:

• A young female patient previously underwent Senning repair for d-TGA in infancy.
• Twelve years post-repair, she presented with symptoms of congestive heart failure.
• Diagnostic imaging, including X-ray, echocardiography, and angiography, confirmed the need for surgical intervention.

Findings:

• The patient was deemed suitable for reoperation at the German Heart Institute Berlin.
• The reoperation was performed with a very good outcome.
• This case highlights the potential for late-onset cardiac dysfunction following Senning repair.

Implications:

• Long-term follow-up of patients with Mustard or Senning repairs is crucial for identifying and managing residual defects and sequelae.
• Reoperation can be a viable and effective therapeutic option for managing late complications, such as congestive heart failure, after these older surgical techniques.
• Successful reoperation can significantly improve patient quality of life and potentially extend the time before heart transplantation becomes necessary.