[Successful two-staged Jatene operation for severe right ventricular dysfunction and tricuspid regurgitation after Senning operation--a case report]

Nihon Kyobu Geka Gakkai Zasshi. 1993 Jan;41(1):115-8.
[Article in Japanese]

Abstract

We report a seven-year-old boy who underwent a successful Jatene procedure seven years after Senning procedure. The modified Senning operation was performed for the treatment of transposition of the great arteries with intact ventricular septum at three years of age. However, he gradually showed the progressive right ventricular failure with tricuspid regurgitation after operation. When he was referred to our hospital, he was in severe right ventricular failure and showed massive tricuspid regurgitation simultaneously with the moderate degree of left ventricular failure. Staged pulmonary artery banding was applied to prepare the left ventricle for Jatene procedure in spite of the presence of left ventricular failure. The systolic pressure ratio of left ventricle to right ventricle was elevated to 0.91 by this banding although the left ventricular ejection fraction decreased from 43% to 30%. And Jatene procedure was successfully performed after three months of preparation period. Catheterization study after Jatene procedure revealed improved right and left ventricular functions with decrease of tricuspid regurgitation. We conclude that the Jatene procedure should be an ideal alternative in patient with right ventricular failure and/or tricuspid regurgitation after an atrial switch operation; the left ventricle could be prepared by an effective pulmonary banding in most instances.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Child
  • Humans
  • Male
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Postoperative Complications*
  • Pulmonary Artery / surgery*
  • Reoperation
  • Stroke Volume
  • Transposition of Great Vessels / physiopathology
  • Transposition of Great Vessels / surgery*
  • Ventricular Function, Right*