Key result
A palliative Senning procedure successfully improved systemic oxygen saturation to 100% and alleviated cyanosis in a 12-year-old male with d-TGA, VSD, and severe pulmonary hypertension.
Why the study?
In D-TGA with regressed left ventricle unable to support systemic circulation after late presentation for arterial switch operation, atrial switch remains an option to improve quality of life and obliterate cyanosis.
Case Report (n=1)
A palliative Senning procedure is a viable management option to alleviate cyanosis and improve quality of life in late-presenting adolescents with D-TGA, VSD, and severe pulmonary hypertension.
May support palliative Senning for cyanosis relief in rare late-presenting cases; hypothesis-generating and should not yet change practice.
Patients with D-TGA with atrial level mixing of systemic and pulmonary blood, the morphological left ventricle supports the low pressure pulmonary circulation and regresses in mass and volume as time passes. The LV once regressed is unable to support the high pressure systemic circulation after ASO. These patients are candidates for early ASO, preferably within 3 weeks of life. As age progresses, the scope of these surgical procedures skews and an atrial switch remains the only option to improve quality of life. In Atrial switch, the pulmonary and systemic circulation is returned into an “in series” circulation and cyanosis is obliterated.
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Satsangi et al. (2020) conducted a case report in d-TGA with VSD and severe pulmonary vascular obstructive disease (n=1). Palliative Senning procedure was evaluated on Clinical improvement and systemic oxygen saturation. A palliative Senning procedure successfully improved systemic oxygen saturation to 100% and alleviated cyanosis in a 12-year-old male with d-TGA, VSD, and severe pulmonary hypertension.
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