The modified Senning operation for cavopulmonary connection with autologous tissue

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 108; no. 2; pp. 377 - 380
• Main Authors: van de Wal, Henry J.C.M., Tanke, Ronald F., Roef, Mark J.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.08.1994; AATS/WTSA; Elsevier
• Subjects: Adolescent; Arteriovenous Shunt, Surgical - methods; Biological and medical sciences; Cardiac Surgical Procedures - methods; Child; Child, Preschool; Follow-Up Studies; Heart Atria - surgery; Heart Defects, Congenital - surgery; Humans; Infant; Medical sciences; Pulmonary Artery - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Treatment Outcome; Tricuspid Valve - abnormalities; Vena Cava, Inferior - surgery; Vena Cava, Superior - surgery; Human; Complex heart disease; Senning operation; Cardiovascular disease; Congenital disease; Treatment; Cardiac valvular disease; Malformation; Surgery; Atresia; Technique; Tricuspid valve; Child
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/S0022-5223(94)70021-4

A modified Senning technique was used for intraatrial channeling of the systemic venous blood into the pulmonary arteries to create a Fontan circulation in 26 children, six with tricuspid atresia and 20 with complex congenital heart disease. In this technique a flap of atrial free wall tissue is used to create an atrial tunnel without artificial material. Eight patients had subaortic stenosis and required a Damus-Kay-Stansel procedure, in addition. Early mortality was two of 26 and late mortality one of 26. Pleural effusion was encountered in 17 of 26 patients, of whom four had a pericardial effusion, in addition. One patient required pacemaker implantation for complete atrioventricular block. Follow-up ranged from 2 months to 5 years. In this period the ability level index rose by one level. No thrombi were encountered in the right atrium/cavopulmonary tunnel. One patient required antiarrhythmic medication. Protein-losing enteropathy was diagnosed in one patient. Conclusion: This modified Senning technique has the advantage of avoiding the use of prosthetic material in the creation of a Fontan circulation and the potential for fewer long-term complications. (J THORAC CARDIOVASC SURG 1994;108:377-80)