Year : 2008 | Volume
: 11 | Issue : 2 | Page : 141--142
Transoesophageal echocardiography during Senning's operation
Shrinivas Gadhinglajkar, Rupa Sreedhar
Department of Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
Department of Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum - 695 011, Kerala
|How to cite this article:|
Gadhinglajkar S, Sreedhar R. Transoesophageal echocardiography during Senning's operation.Ann Card Anaesth 2008;11:141-142
|How to cite this URL:|
Gadhinglajkar S, Sreedhar R. Transoesophageal echocardiography during Senning's operation. Ann Card Anaesth [serial online] 2008 [cited 2022 May 25 ];11:141-142
Available from: https://www.annals.in/text.asp?2008/11/2/141/41598
A 3-year-old male, diagnosed as a case of dextroposed transposition of great arteries (d-TGA) preoperatively, underwent Senning's operation. TOE examination performed after induction of anaesthesia (using Philips Sonos 7500, USA) revealed pulmonary artery (PA) positioned posterior to the aorta [Figure 1] and ventriculoarterial discordance [right ventricle (RV) draining into the aorta and left ventricle (LV) draining into the PA] [Figure 2]. Dynamic left ventricular outflow tract obstruction (LVOTO) was present. Other features were enlarged right atrium and RV; intact interventricular septum (IVS); atrial septal defect (ASD) measuring 7 mm; and normal position of left atrial appendage and coronary arteries. On cardiopulmonary bypass (CPB), after aortic cross-clamping and cardioplegic arrest, Senning's operation was performed in three layers. No flow obstruction was observed in systemic venous chamber and pulmonary venous baffle [Figure 3] after termination of CPB. RV (systemic ventricle) and LV function were good.
Senning's operation is still performed routinely in developing countries. Ventriculoarterial discordance; bulging of IVS toward LV; and the position of PA parallel and posterior to the aorta (double-barrel appearance) are important features associated with d-TGA. During Senning's operation, a baffle is created in the atrium, which redirects systemic venous flow to LV and pulmonary venous flow to RV. Obstruction to the pulmonary and systemic venous pathway  may occur postoperatively, which should be ruled out in the post-CPB period. TOE is indicated for the evaluation of intra- or extra-cardiac baffles  and ventricular function following the Senning's procedure.
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