ABSTRACT Objective: Long-term results after the Senning operation for transposition of the great arteries are little known. Sinus node dysfunction and systemic ventricular dysfunction are crucial in patient survival. We evaluated the results, long term outcome and quality of life in a group of 39 patients. Methods: The study was a retrospective analysis, of 39 (39/40 = 97.5%) surgical surviving patients, submitted to Senning operation, with a mean follow-up time of 14.7 +/– 3.1 years. Electrocardiogram, echocardiogram, and chest radiograph series were performed every 6 months. Thirty six patients of this series underwent Holter study and ergometric test, to evaluate the physical capacity. Three patients living overseas were excluded. Results: There was only one late death (1/39) (late mortality = 2.5%): a 16 year-old patient had a no cardiac death. The actuarial survival was 95.0% (38/40) (simple or with little VSD, TGA). The probability of staying in sinus rhythm, in 39 surviving patients was 77.1% (30) or normal right ventricular function was 76.5% (29), 10 to 20 years after operation. The incidence of sinus node and right ventricular dysfunction increased gradually over time. No re-operations and pacemaker implantation, was performed. Functional class: I = 30 (85.7%) cases and functional class II = 5 (14.3%) cases. Conclusions: Patients with simple TGA submitted to Senning procedure in our experience, presented during late follow-up: 1—Low incidence of right ventricular dysfunction and active arrhythmias; 2—Low mortality and no sudden death recorded; 3—Good quality of life and 4—Satisfactory surgical results (free of re-operation or definitive pacemaker implantation).
Cite this paper
Maluf, M. (2012) Senning operation for correction of the transposition of the great arteries, results, long-term outcome and quality of life. World Journal of Cardiovascular Diseases, 2, 213-219. doi: 10.4236/wjcd.2012.23036.
 Birnie, D., Tometzki, A., Curzio, J., Houston, A., Hood, S., Swan, L., Doig, W., Wilson, N., Jamieson, M., Pollock, J. and Hillis, W.S. (1998) Outcomes of transposition of the great arteries in the era of atrial inflow correction. Heart, 80, 170-173.
 Moons, P., Gewillig, M., Sluysmans, T., Verhaaren, H., Viart, P., Massin, M., Suys, B., Budts, W., Pasquet, A., De Wolf, D. and Vliers, A. (2004) Long term outcome up to 30 years after the Mustard or Senning operation: A nationwide multicentre study in Belgium. Heart, 90, 307- 313. doi:10.1136/hrt.2002.007138
 Kirjavainen, M., Happonen, J.M. and Louhimo, I. (1999) Late results of Senning operation. Journal of Thoracic and Cardiovascular Surgery, 117, 488-495.
 Agnetti, A., Carano, N., Cavalli, C., Tchana, B., Bini, M., Squarcia, U. and Frigiola, A. (2004) Long-term outcome after Senning operation for transposition of the great arteries. Clinical Cardiology, 27, 611-614.
 Gelatt, M., Hamilton, R.M., McCrindle, B.W., Connelly, M., Davis, A., Harris, L., Gow, R.M., Williams, W.G., Trusler, G.A. and Freedom, R.M. (1997) Arrhythmia and mortality after the Mustard procedure: A 30-year single-center experience. Journal of the American College of Cardiology, 29, 194-201.
 Oechslin, E. and Jenni, R. (2000) 40 years after the first atrial switch procedure in patients with transposition of the great arteries: Long-term results in Toronto and Zurich. Thoracic and Cardiovascular Surgeon, 48, 233-237.
 Williams, W.G., Mc Crindle, B.W., Ashburn, D.A., Jonas, R.A., Mavroudis, C. and Blackstone, E.H. (2003) Outcomes of 829 neonates with complete transposition of the great arteries 12-17 years after repair. European Journal Cardio-Thoracic Surgery, 24, 1-9.
 Wells, W.J. and Blackstone, E. (2000) Intermediate outcome after Mustard and Senning procedures: A study by the Congenital Heart Surgeons Society. Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual, 3, 186-197.
 Cochrane, A.D., Karl, T.R. and Mee, R.B. (1993) Staged conversion to arterial switch for late failure of the systemic right ventricle. Annals of Thoracic Surgery, 56, 854-861. doi:10.1016/0003-4975(93)90343-G
 Lima, L.C. (2001) Resultados tardios da corre??o da transposi??o das grandes artérias com comunica??o interatrial com a técnica de Senning. UNIFESP, Tese Mestrado,.
 Canêo, L., Louren?o, D., Silva, R., Franchi, S., Afiune, J., Afiune, C., Mocelin, A., Barbero-Marcial, M. and Jatene, F. (1999) Senning operation with autologous tissue for atrial septum augmentation or pulmonary venous pathway enlargement. Revista Brasileira de Cirurgia Cardiovascular, 14, 298-302
 Lange, R., H?rer, J., Kostolny, M., Cleuziou, J., Vogt, M., Busch, R., Holper, K., Meisner, H., Hess, J. and Schreiber, C. (2006) Presence of a ventricular septal defect and the mustard operation are risk factors for late mortality after the atrial switch operation. Circulation, 114, 1905-1913.
 Bender, H.W. Jr., Stewart, J.R., Merrill, W.H., Hammon, J.W. Jr. and Graham, T.P. Jr. (1989) Ten years’ experience with the Senning operation for transposition of the great arteries: Physiological results and late follow-up. Annals of Thoracic Surgery, 47, 218-223.
 Sarkar, D., Bull, C., Yates, R., Wright, D., Cullen, S., Gewillig, M., Clayton, R., Tunstill, A. and Deanfield, J. (1999) Comparison of long-term outcomes of atrial repair of simple transposition with implications for a late arterial switch strategy. Circulation, 100, II-176–II-181.
 Turina, M., Siebenmann, R., Nussbaumer, P. and Senning, A. (1988) Long-term outlook after atrial correction of transposition of great arteries. Journal of Thoracic and Cardiovascular Surgery, 95, 828-835
 Helbing, W.A., Hansen, B., Ottenkamp, J., Rohmer, J., Chin, J.G., Brom, A.G. and Quaegebeur, J.M. (1994) Long-term results of atrial correction for transposition of the great arteries: Comparison of Mustard and Senning operations. Journal of Thoracic and Cardiovascular Surgery, 108, 363-372.
 Reich, O., Voriskova, M., Ruth, C., Krejcir, M., Marek, J., Skovranek, J., Hucin, B. and Samanek, M. (1997) Long-term ventricular performance after intra-atrial correction of transposition: Left ventricular filling is the major limitation. Heart, 78, 376-381.