The case of 28 year-old female after Senning procedure with persistent atrial flutter and severe triscuspid regurgitation

Abstract

E-mail: jbulum@gmail.com Transposition of the great vessels (TGA) is a rare condition with incidence of 1:5,000. The most common variant is dtransposition or complete transposition. Pivotal surgical procedure (Senning, 1957) has dramatically improved survival. However, typical long term complications include pressure overload of the systemic right ventricle with tricuspid regurgitation and atrial arrhythmias. Most of the patients are in NYHA I-II functional status 30 years after the operation but only 40-50% of them remain in sinus rhythm, while 30% of patients had minimally one episode of atrial flutter. A 28 year-old female was admitted to our Department in November 2011. When she was 9 months old, she underwent Senning procedure because of d-TGA. She was asymptomatic on beta-blocker until the age of 26 when she experienced palpitations and reduced effort tolerance. In addition, she was planning a pregnancy. Echocardiography showed the dilated and hypertrophic systemic right ventricle with reduced systolic function, and moderate to severe tricuspid regurgitation. Atrial conduits have a normal function. Cardiovascular magnetic resonance imaging showed a right ventricular hypertrophy without signs of fibrosis, and preserved Proπireni saaeetak / Extended abstract