초록접수 현황
| 19F-199 | 구연 미채택시 포럼 발표 |
A Modification of the Senning Procedure in the Double-switch Operation: The Triangular Double-door Technique
Hyungtae Kim¹, Si Chan Sung¹, Kwang Ho Choi¹, Hyoung Doo Lee², Hoon Ko², Joung-Hee Byun²
¹Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Republic of Korea, ²Department of Pediatrics, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Republic of Korea
Purpose : In the Senninig procedure, large part of right atrial (RA) wall is used for making a pathway of systemic venous blood into left atrium (LA), which can compromise RA function. Compromised RA function can reduce systemic cardiac output. We developed a modification of the Senning procedure to preserve RA function.
Methods : We made a transverse incision toward interatrial septum at the RA, and then this incision was extended to both superior vena cava and inferior vena cava to make two triangular RA wall flaps and a large triangular RA window. After covering left pulmonary veins (PVs) with interatrial septal flap, intra-atrial baffling was performed to drain systemic venous blood into LA through newly created large interatrial septal defect using bovine pericardial patch. The triangular-shaped RA wall flaps were anastomosed to the pericardium around the opened right PVs, then the created triangular RA window was closed with in situ pericardial flap.
Results : We have adopted this modified Senning procedure into the double-switch operation (DSO) in two consecutive patients with congenitally corrected transposition of the great arteries (ccTGA) since July 2018. The first patient was 31-month old male patient and the second was 27-month old male patient. Those patients were discharged home 14 and 10 days after the operation without systemic and pulmonary venous obstruction, and during 10 and 2-month follow-up.
Conclusion : Our modification of the Senning procedure in the DSO could be an effective surgical option for the anatomic repair of cc-TGA, even though long-term follow-up should be mandatory in the future.
Methods : We made a transverse incision toward interatrial septum at the RA, and then this incision was extended to both superior vena cava and inferior vena cava to make two triangular RA wall flaps and a large triangular RA window. After covering left pulmonary veins (PVs) with interatrial septal flap, intra-atrial baffling was performed to drain systemic venous blood into LA through newly created large interatrial septal defect using bovine pericardial patch. The triangular-shaped RA wall flaps were anastomosed to the pericardium around the opened right PVs, then the created triangular RA window was closed with in situ pericardial flap.
Results : We have adopted this modified Senning procedure into the double-switch operation (DSO) in two consecutive patients with congenitally corrected transposition of the great arteries (ccTGA) since July 2018. The first patient was 31-month old male patient and the second was 27-month old male patient. Those patients were discharged home 14 and 10 days after the operation without systemic and pulmonary venous obstruction, and during 10 and 2-month follow-up.
Conclusion : Our modification of the Senning procedure in the DSO could be an effective surgical option for the anatomic repair of cc-TGA, even though long-term follow-up should be mandatory in the future.
책임저자: Si Chan Sung
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Republic of Korea
발표자: Hyungtae Kim, E-mail : 2719k@naver.com