Perioperative management of an adolescent with transposition of the great arteries, status post Senning procedure, for posterior spinal fusion

Abstract

With advances in surgical techniques and perioperative care, the survival rate of patients with congenital heart disease continues to increase. As such, patients with palliated or corrected congenital heart disease may present for major       surgical procedures. Although alternative techniques are now available for the anatomic repair of patient with  ransposition of the great arteries (TGA), an atrial level baf" e (Mustard or Senning procedure) was previously performed. As these patients age, long-term adverse effects may occur including myocardial dysfunction, rhythm disturbances requiring pacemaker placement, pulmonary hypertension, and baf" e obstruction. We present a case report of a 14 year old girl with TGA, who underwent a Senning procedure during infancy and now presented for posterior spinal fusion in the treatment of kyphoscoliosis. The perioperative care of such patients is discussed.