Senning operation for very low birth weight infant with transposition of the great arteries: one of the smallest cases in the world.

We report a case of a Senning operation for very low birth weight infant weighing 1,168 g with transposition of the great arteries. The patient underwent a Senning operation on 62 days, 1,700 g after the first palliation. In this case, the orifice of the left anterior descending artery was located in sinus 1 (left posterior facing sinus), but we could not find orifices of both right coronary artery and left circumflex artery before the Senning operation. The surgical procedure of the Senning operation is typical one, but we used flesh autopericardial patch to cover the roof of the new pulmonary vein chamber to get an enough size. The patient recovered with no cardiac events after the repair.