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Published on: September 9, 2020
The Senning operation for complete transposition: mid-term physiologic, electrophysiologic, and functional results
W H Merrill1, J R Stewart, J W Hammon
1Department of Cardiac and Thoracic Surgery and the Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Cardiology in the Young
|December 1, 2010
Summary
The Senning operation for complete transposition offers low mortality in children. However, long-term outcomes may be affected by arrhythmias and reduced right ventricular function.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Cardiac Electrophysiology
Background:
- Complete transposition of the great arteries is a critical congenital heart defect.
- The Senning operation is a surgical technique for atrial repair of complete transposition.
- Long-term outcomes and potential complications of the Senning operation require ongoing evaluation.
Purpose of the Study:
- To analyze the surgical results and long-term outcomes of the Senning operation in infants and children with complete transposition.
- To assess operative mortality, late mortality, and functional status post-surgery.
- To identify the incidence of arrhythmias and evaluate right ventricular function after the procedure.
Main Methods:
- Retrospective analysis of 110 infants and children undergoing the Senning operation between 1978 and 1990.
- Evaluation of operative and late mortality, patient follow-up duration, and functional classification (New York Heart Association).
- Postoperative cardiac catheterization, electrophysiologic studies, and Holter monitoring were performed in subsets of patients to assess ventricular function and arrhythmias.
Main Results:
- The operative mortality rate was 5.5%, with one late death. Average follow-up was 48.1 months.
- Right ventricular ejection fraction was depressed in a significant portion of patients, particularly under stress.
- Arrhythmias were common, with 26 patients experiencing significant arrhythmias, including 6 requiring pacemakers. Mild tricuspid regurgitation and superior caval vein obstruction were noted in some patients.
Conclusions:
- The Senning operation can be performed with low operative and late mortality for complete transposition.
- While serious baffle complications are rare, long-term functional status may be impacted by arrhythmias and impaired right ventricular function.
- Most surviving patients achieve good functional class, but careful long-term monitoring is essential.