Senning operation for correction of the transposition of the great arteries, results, long-term outcome and quality of life

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).