Senning With Aortic Translocation and Anatomic Repair for Congenitally Corrected Transposition

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Disease Repair
• Surgical Innovation

Background:

• Congenitally corrected transposition of the great arteries (ccTGA) with ventricular septal defect (VSD) and pulmonic stenosis requires complex surgical repair.
• Traditional methods like atrial switch and Rastelli procedures have limitations.
• Aortic translocation offers an alternative by providing direct left ventricular outflow, potentially minimizing reoperations.

Purpose of the Study:

• To review the institutional experience with Senning with aortic translocation (SAT) for ccTGA with VSD and pulmonic stenosis.
• To evaluate the safety and efficacy of SAT in a pediatric cohort.
• To assess early clinical outcomes and identify potential complications.

Main Methods:

• Retrospective review of 8 pediatric patients undergoing SAT between 2007 and 2017.
• Detailed analysis of associated cardiac anomalies, including situs inversus, dextrocardia, VSDs, atrioventricular valve abnormalities, and pulmonary artery stenosis.
• Documentation of surgical parameters (bypass time, ischemic time) and additional procedures performed.

Main Results:

• No hospital mortality was observed.
• One patient required extracorporeal membrane oxygenation (ECMO) for junctional tachycardia; another needed a pacemaker for heart block.
• Median hospital stay was 31 days, with a mean follow-up of 52 months. All patients showed mild or no aortic regurgitation, though one required reoperation for pulmonary venous baffle obstruction.

Conclusions:

• Senning with aortic translocation (SAT) demonstrates satisfactory patient outcomes despite technical complexity.
• SAT is considered a superior anatomic repair for complex ccTGA defects.
• Longer-term follow-up is necessary to fully assess the durability and need for late interventions.