title: Single-Center Experience With the Senning Procedure in the Current Era.
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.
authors.affiliation: Department of Cardiothoracic Surgery, Children's Medical Center, Dallas, Division of Pediatric Cardiothoracic Surgery, University of Texas Southwestern Medical Center, Texas.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferro
authors.affiliation: Department of Cardiothoracic Surgery, Children's Medical Center, Dallas, Division of Pediatric Cardiothoracic Surgery, University of Texas Southwestern Medical Center, Texas.
authors.forename: Raghav
authors.initials: R
authors.lastname: Murthy
authors.affiliation: Department of Cardiothoracic Surgery, Children's Medical Center, Dallas, Division of Pediatric Cardiothoracic Surgery, University of Texas Southwestern Medical Center, Texas.
authors.forename: Vinod A
authors.initials: VA
authors.lastname: Sebastian
authors.affiliation: Department of Cardiothoracic Surgery, Children's Medical Center, Dallas, Division of Pediatric Cardiothoracic Surgery, University of Texas Southwestern Medical Center, Texas.
authors.forename: Kristine J
authors.initials: KJ
authors.lastname: Guleserian
authors.affiliation: Department of Cardiothoracic Surgery, Children's Medical Center, Dallas, Division of Pediatric Cardiothoracic Surgery, University of Texas Southwestern Medical Center, Texas. Electronic address: Joseph.Forbess@UTSouthwestern.edu.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Forbess
mesh_terms: D000293:Adolescent; D000069278:Arterial Switch Operation / Q000009:adverse effects / Q000401:mortality; D002304:Cardiac Pacing, Artificial; D002648:Child; D002675:Child, Preschool; D000080041:Congenitally Corrected Transposition of the Great Arteries; D018572:Disease-Free Survival; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016027:Heart Transplantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D010138:Pacemaker, Artificial; D018579:Patient Selection; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013781:Texas; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014654:Vascular Patency; D018487:Ventricular Dysfunction, Left / Q000209:etiology
keywords: Arterial switch; Atrial switch; Corrected Transposition; Double switch; Rastelli operation