Late results of Senning operation

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Congenital Heart Disease

Background:

• The Senning operation is a common surgical procedure for d-transposition of the great arteries.
• Long-term outcomes and risk factors for late mortality after the Senning operation are not well-established.
• Sinus node dysfunction and systemic ventricular dysfunction are known complications.

Purpose of the Study:

• To evaluate long-term results after the Senning operation in 100 patients.
• To identify risk factors for late death.
• To determine the incidence of late death, sinus node dysfunction, and right ventricular dysfunction.

Main Methods:

• Retrospective analysis of 100 patients undergoing the Senning operation.
• Mean follow-up duration of 12.8 years with no loss to follow-up.
• Patients categorized into simple (73) and complex (27) groups based on ventricular septal defect; review of ECG, ambulatory ECG, echocardiogram, and chest radiograph.

Main Results:

• Overall mortality rate was 10%; actuarial survival at 15 years was 90% (simple) vs. 78% (complex).
• Probability of sinus rhythm at 15 years was 34% (simple) vs. 7% (complex); normal right ventricular function was 52% (simple) vs. 39% (complex).
• Sinus node dysfunction increased gradually; right ventricular dysfunction increased rapidly after 10 years. Late deaths, arrhythmias, and right ventricular dysfunction were more frequent in the complex group. Right ventricular dysfunction and arrhythmias were risk factors for late death.

Conclusions:

• Long-term follow-up reveals a progressive increase in sinus node and right ventricular dysfunction post-Senning operation.
• Deteriorating right ventricular function is a significant concern requiring vigilant monitoring.
• Early detection and management are essential to preserve cardiac function and improve outcomes in patients who have undergone the Senning operation.