MIDTERM RESULTS OF THE MODIFIED SENNING OPERATION FOR CAVOPULMONARY CONNECTION WITH AUTOLOGOUS TISSUE

The aim of this study was to determine the results and mid-term outcom e of a modified Senning technique using autologous tissue for total ca vopulmonary connection, The study involved 31 children, 8 with tricusp id atresia and 23 with complex congenital heart disease, In this opera tion, a flap of autologous atrial free wall tissue was used to tunnel inferior vena caval blood to the pulmonary arteries, An aditional Damu s-Kay-Stansel operation was required in 9 patients with subaortic obst ruction, Results: the early mortality rate was 16% (5 out of 31 patien ts) and there were four late deaths, Complications: Pleural effusions were encountered in 17 patients, of whom 4 had a concomitant pericardi al effusion, Diaphragmatic paralysis was diagnosed in five patients, o ne of whom underwent surgical plication, Median hospital stay was 26 d ays, The 1- to 5-year actuarial survival was 68.6%. Follow-up ranged f rom 10 months to 7.1 years, mean 3.2 years, A serious atrial arrhythmi a was diagnosed in one patient and another one died, possibly from rhy thm disorders, Exercise tolerance and quality of life has improved in all but one of the survivors, Although follow-up is short, we have thu s far witnessed a low incidence of hemodynamic and rhythm disturbances with this modification of the cavopulmonary connection.