On 21 July 2000, Åke Senning passed away in Zürich, at age 85, after a long illness. Dr. Senning's pioneering contributions to cardiovascular surgery will be an enduring legacy to humanity. He advanced almost every area of cardiac treatment, including open heart surgery, repair of congenital cardiac defects, pacemaker therapy, valve replacement, cardiac transplantation, and balloon angioplasty.
Born in 1915, in Rättvik, Sweden, Åke Senning attended medical school at the University of Uppsala and Stockholm. In 1948, he joined the innovative cardiovascular surgeon Clarence Crafoord, at Sabbatsberg Hospital in Stockholm. There, he helped develop one of the first pump oxygenators for cardiopulmonary bypass, which was successfully used in dogs in 1951. In 1953, this oxygenator was used to extract a left atrial myxoma; the patient—at that time, a young woman—is still alive today. Dr. Senning also promoted the use of hypothermia and cardioplegia and was the first to use elective fibrillation in heart surgery.
In 1956, Dr. Senning became Associate Professor of Experimental Surgery at the University Thoracic Clinic of Karolinska Hospital, in Stockholm. Two years later, he introduced an atrial inversion operation (the Senning repair) for transposition of the great arteries (TGA). In this procedure, the atrial walls were reconstructed with flaps of autogenous tissue, which formed venous and arterial conduits; caval blood was rerouted to the pulmonary artery, while pulmonary venous flow drained into the aorta. This operation dramatically improved the prognosis for children with TGA. The Senning repair was superseded by the Mustard procedure in 1964 but later attracted renewed interest because of its effectiveness. Although the arterial switch procedure is now the preferred approach for treating TGA, the Senning operation remains a satisfactory alternative.
On 8 October 1958, Dr. Senning made another major breakthrough when he placed the first implantable pacemaker in a 43-year-old man with Stokes-Adams syndrome. The pacemaker, designed by Rune Elmquist (of the Elema Company, now owned by St. Jude Medical), used two transistors and was about the size of a hockey puck. Six hours postoperatively, the device failed and had to be replaced by a second, identical model, which worked for 6 weeks. Forty years (and 26 pacemakers) later, the patient was enjoying a normal life at age 83.
In 1958, Dr. Senning also introduced autogenous fascia lata trileaflet valves for the replacement of diseased human aortic valves. These bioprostheses were later modified by other researchers and implanted in hundreds of patients.
In 1961, Dr. Senning moved to Zürich to become Professor of Surgery and Director of the Surgical Clinic A at the University Hospital, where he remained until his retirement in 1985. There, he and his team performed the first heart transplant in Switzerland in 1969. When interviewed about this event, he stated that transplantation is technically simple: “Man muss nur nähen. Und wenn man weiss, wo man nähen muss, ist es kein Problem.” (“One must merely sew. And when one knows where to sew, there is no problem.”)
After the advent of coronary artery bypass surgery in 1967, Dr. Senning helped to promote this operation in Europe. At the University Hospital, he was a colleague of Andreas Grüntzig, who introduced percutaneous transluminal coronary angioplasty clinically in 1977. Dr. Senning provided surgical standby during the first percutaneous transluminal coronary angioplasty procedures and coauthored the early reports about this technique.
The recipient of countless awards and honors, Dr. Senning belonged to various professional surgical societies and was author or coauthor of at least 350 scientific publications.
I knew Åke Senning personally, enjoyed his friendship, and admired his spirit. At his passing, the cardiovascular surgery profession lost a great pioneer and fine human being. He is survived by his wife Ulla and his 4 children (3 sons and a daughter). On behalf of the Texas Heart Institute, I salute Dr. Senning's memory and offer my sincere condolences to his family and colleagues.