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J Thorac Cardiovasc Surg 1994;108:377-380
© 1994 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

The modified Senning operation for cavopulmonary connection with autologous tissue

Nijmegen and Utrecht, The Netherlands

From the Departments of Cardiopulmonary Surgery and Paediatric Cardiology, Sint Radboud University Hospital, Nijmegen, and the Wilhelmina Children's Hospital, Utrecht, University Utrecht, The Netherlands.

Received for publication Dec. 22, 1992. Accepted for publication Jan. 18, 1994. Address for reprints: Henry J. C. M. van de Wal, MD, PhD, Children's Heart Center, Wilhelmina Children's Hospital, Utrecht University, P.O. Box 18009, 3501 CA Utrecht, The Netherlands.

Abstract

A modified Senning technique was used for intraatrial channeling of the systemic venous blood into the pulmonary arteries to create a Fontan circulation in 26 children, six with tricuspid atresia and 20 with complex congenital heart disease. In this technique a flap of atrial free wall tissue is used to create an atrial tunnel without artificial material. Eight patients had subaortic stenosis and required a Damus-Kay-Stansel procedure, in addition. Early mortality was two of 26 and late mortality one of 26. Pleural effusion was encountered in 17 of 26 patients, of whom four had a pericardial effusion, in addition. One patient required pacemaker implantation for complete atrioventricular block. Follow-up ranged from 2 months to 5 years. In this period the ability level index rose by one level. No thrombi were encountered in the right atrium/cavopulmonary tunnel. One patient required antiarrhythmic medication. Protein-losing enteropathy was diagnosed in one patient. Conclusion: This modified Senning technique has the advantage of avoiding the use of prosthetic material in the creation of a Fontan circulation and the potential for fewer long-term complications. (J THORACCARDIOVASCSURG1994;108:377-80)

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