Late results of Senning operation

Objectives: Few data exist for long-term results after the Senning operatio n for transposition of the great arteries. Sinus node dysfunction and syste mic ventricular dysfunction have been the main problems. We evaluated risk factors for late death and the incidence of late death, sinus node dysfunct ion, and right ventricular dysfunction in 100 patients. Methods: The study was a retrospective analysis with a mean follow-up time of 12.8 +/- 3.1 yea rs. No patients were lost to follow-up. Patients were divided in 2 groups a ccording to ventricular septal defect (73 simple, 27 complex), The electroc ardiogram, ambulatory electrocardiogram, echocardiogram, and chest radiogra ph were reviewed for each patient. Results: The overall mortality rate was 10%. The actuarial survival was 90% (simple) and 78% (complex); the probabi lity of staying in sinus rhythm was 34% and 7%, and the probability of norm al right ventricular function was 52% and 39%, respectively, 15 years after operation. The incidence of sinus node dysfunction increased gradually ove r time, although the incidence of right ventricular dysfunction increased r apidly after 10 years of follow-up. Late deaths, arrhythmias, and right ven tricular dysfunction were significantly more frequent in the complex group. Right ventricular dysfunction and active arrhythmias were risk factors for late death. Conclusion: Long-term follow-up after the Senning operation sh ows increasing incidence of sinus node dysfunction and right ventricular dy sfunction over time. Deteriorating right ventricular function is a major co ncern. Its early recognition and initiation of appropriate management to pr eserve cardiac function is an important follow-up goal.