Single-Center Experience With the Senning Procedure in the Current Era

Giuseppe Ferro, Raghav Murthy, Vinod A. Sebastian, Kristine J. Guleserian, Joseph M. Forbess*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The Senning procedure is an operative technique for atrial inversion in congenital heart anomalies. We sought to evaluate our contemporary outcomes employing this technique. A retrospective analysis of all patients who underwent the Senning procedure at our institution was performed. Hospital records were reviewed, and follow-up data were obtained to evaluate outcomes. Overall, a total of 19 patients underwent a Senning procedure between August 2005 and July 2014. Median age at repair was 594 days (range: 5 days to 15 years). Of those, 7 patients underwent a combined Senning-Rastelli operation and 10 patients underwent a double switch operation (arterial switch or atrial switch). Primary diagnosis was congenitally corrected transposition of the great arteries (cc-TGA) in 17 patients. Associated lesions included ventricular septal defect (n = 10), pulmonary stenosis or atresia (n = 7), and Ebstein׳s anomaly of the tricuspid valve (n = 4). There was an operative death (5%). In all, 2 patients required superior vena cava baffle revision in the operating room. No new pulmonary venous or systemic venous baffle obstruction was observed during follow-up. A total of 5 (26%) patients developed heart block requiring pacemaker implantation. Actuarial survival was 81% at 5 years with a median follow-up of 38 months. The 2 patients in the cc-TGA group were subsequently transplanted. Surviving patients (n = 15) are all well at the last clinical follow-up, most with normal biventricular function. In conclusion, the Senning procedure offers excellent outcomes with regard to systemic and pulmonary venous baffle patency. Results in patients with cc-TGA, however, are affected by significant early mortality after Senning-Rastelli and incidence of left ventricular dysfunction after double switch; which should be considered during patient selection and surgical planning.

Original languageEnglish (US)
Pages (from-to)514-520
Number of pages7
JournalSeminars in Thoracic and Cardiovascular Surgery
Volume28
Issue number2
DOIs
StatePublished - Feb 2 2016

Fingerprint

Arterial Switch Operation
Ebstein Anomaly
Pulmonary Atresia
Lung
Pulmonary Valve Stenosis
Heart Block
Superior Vena Cava
Tricuspid Valve
Hospital Records
Ventricular Heart Septal Defects
Left Ventricular Dysfunction
Operating Rooms
Patient Selection
Survival
Mortality
Incidence
Congenitally corrected transposition of the great arteries

Keywords

  • Arterial switch
  • Atrial switch
  • Corrected Transposition
  • Double switch
  • Rastelli operation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ferro, Giuseppe ; Murthy, Raghav ; Sebastian, Vinod A. ; Guleserian, Kristine J. ; Forbess, Joseph M. / Single-Center Experience With the Senning Procedure in the Current Era. In: Seminars in Thoracic and Cardiovascular Surgery. 2016 ; Vol. 28, No. 2. pp. 514-520.
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Single-Center Experience With the Senning Procedure in the Current Era. / Ferro, Giuseppe; Murthy, Raghav; Sebastian, Vinod A.; Guleserian, Kristine J.; Forbess, Joseph M.

In: Seminars in Thoracic and Cardiovascular Surgery, Vol. 28, No. 2, 02.02.2016, p. 514-520.

Research output: Contribution to journalArticle

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AU - Ferro, Giuseppe

AU - Murthy, Raghav

AU - Sebastian, Vinod A.

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AB - The Senning procedure is an operative technique for atrial inversion in congenital heart anomalies. We sought to evaluate our contemporary outcomes employing this technique. A retrospective analysis of all patients who underwent the Senning procedure at our institution was performed. Hospital records were reviewed, and follow-up data were obtained to evaluate outcomes. Overall, a total of 19 patients underwent a Senning procedure between August 2005 and July 2014. Median age at repair was 594 days (range: 5 days to 15 years). Of those, 7 patients underwent a combined Senning-Rastelli operation and 10 patients underwent a double switch operation (arterial switch or atrial switch). Primary diagnosis was congenitally corrected transposition of the great arteries (cc-TGA) in 17 patients. Associated lesions included ventricular septal defect (n = 10), pulmonary stenosis or atresia (n = 7), and Ebstein׳s anomaly of the tricuspid valve (n = 4). There was an operative death (5%). In all, 2 patients required superior vena cava baffle revision in the operating room. No new pulmonary venous or systemic venous baffle obstruction was observed during follow-up. A total of 5 (26%) patients developed heart block requiring pacemaker implantation. Actuarial survival was 81% at 5 years with a median follow-up of 38 months. The 2 patients in the cc-TGA group were subsequently transplanted. Surviving patients (n = 15) are all well at the last clinical follow-up, most with normal biventricular function. In conclusion, the Senning procedure offers excellent outcomes with regard to systemic and pulmonary venous baffle patency. Results in patients with cc-TGA, however, are affected by significant early mortality after Senning-Rastelli and incidence of left ventricular dysfunction after double switch; which should be considered during patient selection and surgical planning.

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