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Technical advances in the Senning operation.

F Alvarez Diaz, J Cabo Salvador, J Rivas

    The Thoracic and Cardiovascular Surgeon
    |April 1, 1983
    PubMed
    Summary
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    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.

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  • 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.