The Senning operation for transposition of the great arteries (TGA) in 59 pediatric patients showed a 15.2% mortality rate. Technical modifications to the Senning procedure may improve outcomes for TGA repair.
Area of Science:
Pediatric Cardiac Surgery
Congenital Heart Disease
Cardiovascular Surgery
Background:
Transposition of the great arteries (TGA) is a critical congenital heart defect.
The Senning operation is a common surgical repair for TGA.
Prior interventions like Rashkind septotomy and Blalock-Hanlon septectomy were noted.
Purpose of the Study:
To evaluate the outcomes of the Senning operation in 59 pediatric patients with TGA.
To present and assess the impact of technical modifications to the Senning procedure.
To analyze hospital mortality and complication rates associated with the modified Senning operation.
Main Methods:
Retrospective analysis of 59 pediatric patients undergoing the Senning operation for TGA between March 1978.
Description of technical modifications including atrial incisions, left atrial windows, and flap techniques.
Review of patient demographics, associated cardiac defects (VSD, PS, PDA), prior procedures, and operative outcomes.
Main Results:
Hospital mortality was 15.2% (9 deaths) due to low cardiac output or hypoxemia.
Complications included neurological issues (2 patients), chylothorax (4 patients), and transient junctional rhythm (18 patients).
Technical modifications included specific atrial incisions, left atrial windows, and use of the left atrial appendage as a flap.
Conclusions:
The Senning operation, with described technical modifications, was performed on 59 pediatric TGA patients.
Hospital mortality was 15.2%, with low cardiac output as the primary cause of death.
The authors suggest their technical modifications may contribute to improving the Senning operation's efficacy.