Modified Senning Procedure for Treatment of Transposition of the Great Arteries with Crisscross Heart

TL;DR

A nine-month-old infant with a rare heart defect called crisscross heart and transposition of the great arteries underwent a modified Senning procedure for treatment.

Contribution

The paper presents a modified Senning procedure using the pericardial sac for a rare and complex congenital heart defect.

Findings

The modified Senning procedure was successfully applied in a crisscross heart with transposition of the great arteries.

The surgery involved a 147-minute cardiopulmonary bypass with nine minutes of total circulatory arrest.

Crisscross heart is a rare condition, occurring in 0.1% of congenital heart diseases.

Abstract

A nine-month-old female infant diagnosed with transposition of the great
arteries with symptoms of heart failure associated with cyanosis and
difficulty in gaining weight was referred to our center with late diagnosis
(at nine months of age).

Cardiomegaly; attenuated peripheral vascular markings.

Electrocardiography: Sinus rhythm with biventricular overload and aberrantly
conducted supraventricular extra systoles.

Wide atrial septal defect, ventricular axis torsion with concordant
atrioventricular connection and discordant ventriculoarterial
connection.

Concordant atrioventricular connection, right ventricle positioned superiorly
and left ventricle positioned inferiorly; discordant ventriculoarterial
connection with right ventricle connected to the aorta and left ventricle
connected to pulmonary artery.

Crisscross heart is a rare congenital heart defect, accounting for 0.1% of
congenital heart diseases. It consists of the 90º rotation of ventricles’
axis in relation to their normal position; therefore, ventricles are
positioned in the superior-inferior direction rather than
anterior-posterior. Most cases have associated cardiac anomalies, and in
this case, it is associated with transposition of the great arteries. The
complexity and rarity of its occurrence make diagnosis and surgical
treatment challenging.

Modified Senning procedure using the pericardial sac in the construction of a
tunnel from pulmonary veins to the right atrium. Cardiopulmonary bypass time
of 147 minutes with nine minutes of total circulatory arrest.

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