THE MODIFIED SENNING OPERATION FOR CAVOPULMONARY CONNECTION WITH AUTOLOGOUS TISSUE

A modified Senning technique was used for intraatrial channeling of th e systemic venous blood into the pulmonary arteries to create a Fontan circulation in 26 children, six with tricuspid atresia and 20 with co mplex congenital heart disease. In this technique a flap of atrial fre e wall tissue is used to create an atrial tunnel without artificial ma terial. Eight patients had subaortic stenosis and required a Damus-Kay -Stansel procedure, in addition. Early mortality was two of 26 and lat e mortality one of 26. Pleural effusion was encountered in 17 of 26 pa tients, of whom four had a pericardial effusion, in addition. One pati ent required pacemaker implantation for complete atrioventricular bloc k. Follow-up ranged from 2 months to 5 years. In this period the abili ty level index rose by one level. No thrombi were encountered in the r ight atrium/cavopulmonary tunnel. One patient required antiarrhythmic medication. Protein-losing enteropathy was diagnosed in one patient. C onclusion: This modified Senning technique has the advantage of avoidi ng the use of prosthetic material in the creation of a Fontan circulat ion and the potential for fewer long-term complications.