title: Mid-term results of the modified Senning operation for cavopulmonary connection with autologous tissue.
abstract: The aim of this study was to determine the results and mid-term outcome of a modified Senning technique using autologous tissue for total cavopulmonary connection. The study involved 31 children, 8 with tricuspid atresia and 23 with complex congenital heart disease. In this operation, a flap of autologous atrial free wall tissue was used to tunnel inferior vena caval blood to the pulmonary arteries. An additional Damus-Kay-Stansel operation was required in 9 patients with subaortic obstruction.
  
  
  RESULTS
  the early mortality rate was 16% (5 out of 31 patients) and there were four late deaths.
  
  
  RESULTS
  Pleural effusions were encountered in 17 patients, of whom 4 had a concomitant pericardial effusion. Diaphragmatic paralysis was diagnosed in five patients, one of whom underwent surgical plication. Median hospital stay was 26 days. The 1- to 5-year actuarial survival was 68.6%. Follow-up ranged from 10 months to 7.1 years, mean 3.2 years. A serious atrial arrhythmia was diagnosed in one patient and another one died, possibly from rhythm disorders. Exercise tolerance and quality of life has improved in all but one of the survivors. Although follow-up is short, we have thus far witnessed a low incidence of hemodynamic and rhythm disturbances with this modification of the cavopulmonary connection.
authors.affiliation: Children's Heart Centre, Wilhelmina Children's Hospital, University of Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Benatar
authors.forename: R
authors.initials: R
authors.lastname: Tanke
authors.forename: M
authors.initials: M
authors.lastname: Roef
authors.forename: E J
authors.initials: EJ
authors.lastname: Meyboom
authors.forename: H J
authors.initials: HJ
authors.lastname: Van de Wal
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000714:Anastomosis, Surgical; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000379:methods; D006325:Heart Atria / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology; D010996:Pleural Effusion / Q000209:etiology; D011183:Postoperative Complications; D011651:Pulmonary Artery / Q000601:surgery*; D012133:Respiratory Paralysis / Q000209:etiology; D013524:Surgical Flaps; D015996:Survival Rate; D014261:Tricuspid Valve / Q000002:abnormalities / Q000601:surgery; D014682:Vena Cava, Inferior / Q000601:surgery*