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J Thorac Cardiovasc Surg 1995;109:1264
© 1995 Mosby, Inc.

LETTERS TO THE EDITOR

Modified Senning operation for cavopulmonary connection with autologous tissue

Great Ormond Street Hospital
London, United Kingdom

To the Editor:

Van de Wal, Tanke, and Roef ¹ described a modified technique of total cavopulmonary connection. I am not sure why the authors call this a modification of the Senning technique because the flaps described in their paper are different from the ones used in Senning's procedure. Their flaps are actually reversed. The technique of transecting the superior vena cava close to the right atrium (van de Wal, Tanke, and Roef, ¹ Fig. 1 , G) is potentially dangerous and may be a cause of the rhythm disturbances that the authors observed. The incidence of pleural effusions (77%) is high, and the authors do not mention fenestration in the pathway or creation of an adjustable atrial septal defect, which can considerably reduce the incidence of both pleural and pericardial effusions.

The principle of the technique described by the authors was suggested by Milo and colleagues ² in 1980. It was also proposed by Fantidis and colleagues. ³ We have been using total cavopulmonary connection with atrial flaps since 1988, ⁴ and others have published their experience. ^{5, 6}

12/8/61691

References

1. van de Wal HJCM, Tanke RF, Roef MJ. The modified Senning operation for cavopulmonary connection with autologous tissue. J THORAC CARDIOVASC SURG 1994;108:377-80.[Abstract/Free Full Text]
   
2. Milo S, Ho SY, Anderson RH. Hypoplastic left heart syndrome: Can this malformation be treated surgically? Thorax 1980;35:351-4.[Abstract/Free Full Text]
   
3. Fantidis P, Cabo Salvador J, Fernandez Ruiz MA, et al. A new surgical technique for orthoterminal correction: experimental development. Ann Thorac Surg 1985;39:450-5.[Abstract]
   
4. Stark J, Kostelka M. The use of the right atrial flap in total cavopulmonary connection. J Card Surg 1991;6:361-6.
   
5. Chu SH, Leu MR, Chuang CD, Wang JK. Total cavopulmonary connection: a modified technique without prosthetic material. J Card Surg 1991;6:294-8.[Medline]
   
6. Perryman RA. Autogenous atrial tunnel for direct cavopulmonary connection in infants and small children. Ann Thorac Surg 1991;51:508-10.[Abstract]
   

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Stark, J. Search for Related Content PubMed PubMed Citation Articles by Stark, J.