Abstract
Background: The Senning operation for transposition of the great arteries (TGA) was first introduced by Senning in 1959 and was revived by Quaegebeur et al. in the late 1970s, thus becoming the intervention of choice for the correction of TGA in many centers.
Hypothesis: The purpose of this study was to evaluate the long‐term follow‐up of a group of patients undergoing surgery with the Senning procedure for TGA.
Methods: From November 1978 to November 1987, 73 consecutive patients underwent the Senning operation. The 70 survivors had an average follow‐up of 19 years (16‐25 years).
Results: (1) Cardiac rhythm: with time there was a progressive decrease in stable sinus rhythm (60% after 20 years) and a progressive increase of supraventricular tachyarrhythmias requiring therapy (10% after 20 years). (2) Right ventricular function: 20% of the patients had reduced ejection fraction. (3) Late mortality: in the last 12 years of follow‐up years there were two sudden deaths (2.8%). (4) Functional status: 80% of patients were in NYHA class I, 17% in class II, and 3% in class III.
Conclusions: Our results confirm that the patients who undergo the Senning procedure have a progressive loss of sinus rhythm, an increase in active arrhythmias, and other important adverse outcomes such as late sudden death and a decrease in right ventricular function; however, most patients (93% in our series) are alive and in good functional status.
Keywords: transposition, Senning, arrhythmias, right ventricle
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References
- 1. Senning A: Surgical correction of transposition of the great vessels. Surgery 1959; 45: 966–980 [PubMed] [Google Scholar]
- 2. Quaegebeur JM, Rohmer J, Brom AG: Revival of the Senning operation for treatment of transposition of the great arteries. Thorax 1977; 32: 517–524 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Bender HW, Graham TP, Boucek RJ, Waiker WE, Buerth RG: Comparative operative results of the Senning and Mustard procedures for transposition of the great arteries. Circulation 1980; 62 (suppl 1): 197–203 [PubMed] [Google Scholar]
- 4. Graham TP, Burger J, Bender HW, Hammon JW, Boucek RJ, Appleton S: Improved right ventricular function after intraatrial repair of transposition of the great arteries. Circulation 1985; 72 (suppl II): 1145–1151 [PubMed] [Google Scholar]
- 5. Bender HW, Stewart JR, Menill WH, Hammon JW, Graham TP: Ten years' experience with the Senning operation for transposition of the great arteries: Physiological results and late follow‐up. Ann Thorac Surg 1989; 47: 218–223 [DOI] [PubMed] [Google Scholar]
- 6. Turina M, Siebenmann R, Nussbaumer P, Senning A: Long‐term outlook after atrial correction of transposition of great arteries. J Thorac Cardiovasc Surg 1988; 95: 828–835 [PubMed] [Google Scholar]
- 7. Ziegler RF: Electrocardiographic Study in Normal Infant and Children, p. 128–129. Springfield, Ill.: Charles C Thomas, 1951. [Google Scholar]
- 8. Macfarlane PW, Lawne T: Comprehensive Electrocardiography, 3, p. 1442 Elmsford, N. Y.: Pergamon Press, 1989. [Google Scholar]
- 9. Menil WH, Stewart JR, Hammon JW, Johns JA, Bender HW: The Senning operation for complete transposition: Mean‐term physiologic, electrophysiologic and functional results. Cardiol Young 1991; 1: 80–83 [DOI] [PubMed] [Google Scholar]
- 10. Trusler GA, Williarns WG, Dunkan KF, Hesslein PS, Benson LN, Freedom RM, Izukawa T, Olley PM: Results with the Mustard operation in simple transposition of the great arteries 1963‐1985. Ann Surg 1987; 206: 251–260 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. Deanfield JE, Camm AJ, Macartney F, Cartwright T, Douglas J, Drew J, de Leval M, Stark J: Arrhythmia and late mortality after Mustard and Senning operation for transposition of the great arteries: An eight‐year prospective study. J Thorac Cardiovasc Surg 1988; 96 (4): 569–576 [PubMed] [Google Scholar]
- 12. Deanfield JE, Cullen S, Gewillig M: Arrhythmias after surgery for complete transposition: Do they matter? Cardiol Young 1991; 1: 91–96 [DOI] [PubMed] [Google Scholar]
- 13. Myridakis DJ, Ehlers KH, Engie MA: Late follow‐up after venous switch operation for simple and complex transposition of the great arteries. Am J Cardiol 1994; 74: 1030–1036 [DOI] [PubMed] [Google Scholar]
- 14. Kirjavainen M, Happonen JM, Louhimo I: Late results of Senning operation. J Thorac Cardiovasc Surg 1999; 117 (3): 488–495 [DOI] [PubMed] [Google Scholar]
- 15. Wilson N, Clarkson PM, Barratt‐Boyes BG: Long‐term outcome after the Mustard repair for simple transposition of the great arteries. J Am Coll Cardiol 1998; 32 (3): 758–765 [DOI] [PubMed] [Google Scholar]
- 16. Deanfield JE: Intra‐atrial repair of transposition: Late results and management problems. J Thorac Cardiovasc Surg 1999; 117 (3): 486–487 [DOI] [PubMed] [Google Scholar]
- 17. Haemmerli M, Boles M, Friedli B: Electrophysiological studies after the Mustard and Senning operation for complete transposition. Do they have prognostic value? Int J Cardiol 1990; 27: 167–173 [DOI] [PubMed] [Google Scholar]
- 18. Garson A Jr: Chronic postoperative arrhythmia In Pediatric Arrhythmias. Electrophysiology and Pacing (Eds. Gillette PC, Garson A., Jr), p. 667–678. Philadelphia: W. B. Saunders, 1990. [Google Scholar]
- 19. Redington A: Functional assessment of the heart after corrective surgery for complete transposition. Cardiol Young 1991; 1: 84–90 [DOI] [PubMed] [Google Scholar]
- 20. Hurwitz RA, Caldwell RL, Girod DA: Right ventricular systolic function in adolescents and young adults after Mustard operation for transposition of the great arteries. Am J Cardiol 1996; 77: 294–297 [DOI] [PubMed] [Google Scholar]