To switch or not to switch? The Senning alternative

Area of Science:

• Pediatric Cardiology
• Congenital Heart Surgery
• Neonatal Intensive Care

Background:

• Simple arterial transposition is a critical congenital heart defect requiring timely intervention.
• Historical management strategies varied, influencing patient outcomes.
• The Senning operation was a primary approach for this condition during the study period.

Purpose of the Study:

• To evaluate the long-term outcomes of infants with simple arterial transposition treated with the Senning operation.
• To establish actuarial survival rates for this cohort.
• To provide data for comparing interatrial repair with arterial switch protocols.

Main Methods:

• Retrospective analysis of 100 consecutive patients with simple arterial transposition.
• Patients admitted within the first two weeks of life between 1978 and 1986.
• Management focused on the Senning operation as the definitive procedure.

Main Results:

• 12% preoperative mortality, with deaths due to perinatal hypoxia and catheterization complications.
• Four operative deaths and two late deaths occurred.
• Actuarial survival was 84% at 5 years and 81% at 9 years.
• Postoperative attrition rate was 0.4 deaths per 100 patient-years.

Conclusions:

• The Senning operation achieved a favorable long-term survival rate for simple arterial transposition in this cohort.
• Actuarial survival is a crucial metric for comparing different treatment protocols.
• Understanding mortality patterns (preoperative, perioperative, postoperative) is essential for optimizing care.