title: Late outcome of 132 Senning procedures after 20 years of follow-up.
abstract: BACKGROUND
  Risk factors and rates of reoperation, arrhythmias, systemic right ventricular dysfunction (RVD), and late death after a Senning procedure were investigated.
  
  
  METHODS
  One-hundred thirty-two patients underwent a Senning operation between 1977 and 2004 (105 simple and 27 complex transpositions of the great arteries). Mean follow-up time was 19.5 ± 6.6 years. Surviving patients were evaluated by transthoracic echocardiography and electrocardiography. Right ventricular function was assessed in 70 patients by isotopic ventriculography or magnetic resonance imaging.
  
  
  RESULTS
  Operative and late mortality were 5.3% (7/132) and 9.6% (12/125), respectively. Nine patients were reoperated for left ventricular outflow tract obstruction or baffle stenosis. Survival rate was 91.5%, 91%, 89%, and 88% at 1, 5, 10, and 20 years, respectively. Probability of maintaining permanent sinus rhythm was 80%, 65%, 55%, and 44%. Twelve patients required pacemaker implantation. Probability of no supraventricular tachycardia, atrial flutter/fibrillation or ventricular tachycardia was 95.5%, 91.5%, 88%, and 75%, respectively. These parameters were similar for simple and complex transposition. Probability of right ventricular ejection fraction >40% was 100% at 5 and 10 years, and 98% at 20 years for simple transposition, and 100%, 92%, and 58% for complex transposition. This difference was statistically significant. Risk factors for RVD were complex transposition (p < 0.001), body weight (p = 0.008), no cardioplegia (p < 0.001), and tricuspid valve regurgitation (p = 0.004).
  
  
  CONCLUSIONS
  Senning procedure results in very good long-term survival out to 20 years. Both RVD and baffle stenosis were rare, but there was a concerning incidence of arrhythmia over time suggesting careful long-term surveillance.
authors.affiliation: Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, University of Bordeaux II, Bordeaux, France. francois.roubertie@chu-bordeaux.fr
authors.forename: François
authors.initials: F
authors.lastname: Roubertie
authors.forename: Jean-Benoît
authors.initials: JB
authors.lastname: Thambo
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bretonneau
authors.forename: Xavier
authors.initials: X
authors.lastname: Iriart
authors.forename: Nadine
authors.initials: N
authors.lastname: Laborde
authors.forename: Eugène
authors.initials: E
authors.lastname: Baudet
authors.forename: Xavier
authors.initials: X
authors.lastname: Roques
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009017:Morbidity; D012086:Reoperation; D014188:Transposition of Great Vessels / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000209:etiology*