Senning A
Ann Surg. 1975 Sep;182(3):287-92. doi: 10.1097/00000658-197509000-00011.
Inversion of the atrial flow in transposition of the great arteries is achieved in the following way: the remaining atrial septum is detached from behind, leaving it as a flap between both AV-valves. The incision is continued into the coronary sinus and the Vena magna cordis to the base of the left atrial appendage along the mitral ring. The resulting flap from the split coronary sinus is sutured to the left atrial wall in front of the left side pulmonary veins, thus forming a septum dorsal to the caval veins, diverting the left pulmonary venous blood to the right side. The atrial septal flap is reattached in front of the caval vein orifices. In 50 cases a small Dacron patch was used to complete the midportion of the new septum. Six patients died and so far we have encountered one superior Vena cava stenosis and one pulmonary vein stenosis. In 16 patients completion of the midportion of the new atrial septum was done with a partially excised flap from the right atrial wall still attached to the Vena cava inferior. This method resulted in 3 operative deaths. In 42 of 58 survivors the ECG has been repeatedly controlled 3 months to 6 years postoperatively. Thirty-six of the 42 patients have sinus rhythm, 4 vary between nodal and sinus-rhythm and 2 have a total AV-dissociation.
将剩余的房间隔从后方游离，使其成为两个房室瓣之间的一个瓣片。切口沿二尖瓣环延伸至冠状窦及大心静脉，直至左心耳基部。将切开的冠状窦形成的瓣片缝合至左侧肺静脉前方的左心房壁，从而在腔静脉背侧形成一个隔膜，使左肺静脉血转向右侧。房间隔瓣片重新附着于腔静脉开口前方。50例患者使用一小片涤纶补片来完成新隔膜的中部。6例患者死亡，目前我们遇到1例上腔静脉狭窄和1例肺静脉狭窄。16例患者用一片仍附着于下腔静脉的部分切除的右心房壁瓣片来完成新房间隔的中部。该方法导致3例手术死亡。58例幸存者中的42例在术后3个月至6年期间多次进行心电图检查。42例患者中36例为窦性心律，4例在结性心律和窦性心律之间变化，2例存在完全性房室分离。
