Senning Procedure
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Senning Procedure
The Senning procedure is an atrial switch heart operation performed to treat transposition of the great arteries. It is named after its inventor, the Swedish cardiac surgeon Åke Senning (1915–2000), also known for implanting the first permanent cardiac pacemaker in 1958. Brief History This procedure, a form of atrial switch, was developed and first performed by Senning in 1957 as a treatment for d-TGA (dextro-Transposition of the great arteries) before improvements in cardiopulmonary bypass made more curative surgical techniques feasible.Atrial Switch Operation: Past, Present, and Future. Konstantinov IE, Alexi-Meskishvili VV, Williams WG et al.Ann Thorac Surg 2004;77:2250 – 8 In this congenital heart defect, the venous circulation drains into the right ventricle but from this chamber, blood is directed towards the systemic circulation through the aorta. This is also expressed by the term ventriculoarterial discordance, that is the ventricles are connected to the wrong great ...
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Atrial Switch
Atrial switch is a heart operation performed to treat dextro-Transposition of the great arteries. It involves the construction of an atrial baffle which redirects the blood coming into the atria to restore the connection between systemic and pulmonary circulation. Two variants of the atrial switch operation developed – the Senning procedure (1950s) which uses the patient's own tissue (pericardium) to construct the baffle, and the Mustard procedure (1960s), which uses a synthetic material. It has largely been replaced by the arterial switch operation Arterial switch operation (ASO) or arterial switch, is an open heart surgical procedure used to correct dextro-transposition of the great arteries (d-TGA). Its development was pioneered by Canadian cardiac surgeon William Mustard and it was na .... The operation is more commonly performed in developing countries, where the condition frequently presents late. References Cardiac surgery {{cardiology-stub ...
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Transposition Of The Great Arteries
Transposition of the great vessels (TGV) is a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels: superior and/or inferior venae cavae, pulmonary artery, pulmonary veins, and aorta. Congenital heart diseases involving only the primary arteries (pulmonary artery and aorta) belong to a sub-group called transposition of the great arteries (TGA), which is considered the most common congenital heart lesion that presents in neonates. Types Transposed vessels can present with atriovenous, ventriculoarterial and/or arteriovenous discordance. The effects may range from a slight change in blood pressure to an interruption in circulation depending on the nature and degree of the misplacement, and on which specific vessels are involved. Although "transposed" literally means "swapped", many types of TGV involve vessels that are in abnormal positions, while not actually being swapped with each other. The terms TGV and TGA are most c ...
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Åke Senning
Åke Senning (* 14 December 1915 in Rättvik, Sweden; † 21 July 2000 in Zurich, Switzerland) was a Swedish cardiac surgeon who worked at Zurich University Hospital from 1961 until his retirement in 1985. Biography Åke Senning was born to the Swedish veterinarian David Senning and the nurse Elly Senning, née Säfström. He finished his schooling in Uppsala with the baccalaureate. He actually wanted to become an engineer. However, as a nurse in World War 1, his mother persuaded him to study medicine. He subsequently completed the pre-clinical part of his studies in Uppsala, the clinical part and his state examination in Stockholm in 1948. His subsequent further training in Stockholm included general surgery, orthopaedics and thoracic and neurosurgery. Clarence Crafoord introduced him to the field of cardiac surgery in 1948. The influence of this eminent surgeon, who had a major impact on thoracic and cardiac surgery, sparked Senning's love of cardiac surgery and thus hel ...
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Artificial Pacemaker
An artificial cardiac pacemaker (or artificial pacemaker, so as not to be confused with the natural cardiac pacemaker) or pacemaker is a medical device that generates electrical impulses delivered by electrodes to the chambers of the heart either the upper atria, or lower ventricles to cause the targeted chambers to contract and pump blood. By doing so, the pacemaker regulates the function of the electrical conduction system of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or because there is a block in the heart's electrical conduction system. Modern pacemakers are externally programmable and allow a cardiologist, particularly a cardiac electrophysiologist, to select the optimal pacing modes for individual patients. Most pacemakers are on demand, in which the stimulation of the heart is based on the dynamic demand of the circulatory system. Others send out a fixed rate of ...
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Dextro-Transposition Of The Great Arteries
dextro-Transposition of the great arteries (d-Transposition of the great arteries, dextro-TGA, or d-TGA) is a potentially life-threatening birth defect in the large arteries of the heart. The primary arteries (the aorta and the pulmonary artery) are transposed. It is called a cyanotic congenital heart defect (CHD) because the newborn infant turns blue from lack of oxygen. In segmental analysis, this condition is described as ventriculoarterial discordance with atrioventricular concordance, or just ventriculoarterial discordance. d-TGA is often referred to simply as transposition of the great arteries (TGA); however, TGA is a more general term which may also refer to levo-transposition of the great arteries (l-TGA).Another term commonly used to refer to both d-TGA and l-TGA is transposition of the great vessels (TGV), although this term might have an even broader meaning than TGA. Prenatally, a baby with d-TGA experiences no symptoms as the lungs will not be used until after ...
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Cardiopulmonary Bypass
Cardiopulmonary bypass (CPB) is a technique in which a machine temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and oxygen to the body. The CPB pump itself is often referred to as a heart–lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists. CPB is a form of extracorporeal circulation. Extracorporeal membrane oxygenation is generally used for longer-term treatment. CPB mechanically circulates and oxygenates blood for the body while bypassing the heart and lungs. It uses a heart–lung machine to maintain perfusion to other body organs and tissues while the surgeon works in a bloodless surgical field. The surgeon places a cannula in the right atrium, vena cava, or femoral vein to withdraw blood from the body. Venous blood is removed from the body by the cannula and then filtered, cooled or warmed, and oxygenated before it is returned to the body by a mechanical pump. The cannula used ...
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Levo-Transposition Of The Great Arteries
Levo-Transposition of the great arteries is an acyanotic congenital heart defect in which the primary arteries (the aorta and the pulmonary artery) are transposed, with the aorta anterior and to the left of the pulmonary artery; the morphological left and right ventricles with their corresponding atrioventricular valves are also transposed. Use of the term "corrected" has been disputed by many due to the frequent occurrence of other abnormalities and or acquired disorders in l-TGA patients. In segmental analysis, this condition is described as atrioventricular discordance (ventricular inversion) with ventriculoarterial discordance. l-TGA is often referred to simply as transposition of the great arteries (TGA); however, TGA is a more general term which may also refer to dextro-transposition of the great arteries (d-TGA). Signs and symptoms Simple l-TGA does not immediately produce any visually identifiable symptoms, but since each ventricle is intended to handle different blood ...
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D-TGA
dextro-Transposition of the great arteries (d-Transposition of the great arteries, dextro-TGA, or d-TGA) is a potentially life-threatening birth defect in the large arteries of the heart. The primary arteries (the aorta and the pulmonary artery) are transposed. It is called a cyanotic congenital heart defect (CHD) because the newborn infant turns blue from lack of oxygen. In segmental analysis, this condition is described as ventriculoarterial discordance with atrioventricular concordance, or just ventriculoarterial discordance. d-TGA is often referred to simply as transposition of the great arteries (TGA); however, TGA is a more general term which may also refer to levo-transposition of the great arteries (l-TGA).Another term commonly used to refer to both d-TGA and l-TGA is transposition of the great vessels (TGV), although this term might have an even broader meaning than TGA. Prenatally, a baby with d-TGA experiences no symptoms as the lungs will not be used until after ...
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Mustard Procedure
The Mustard procedure was developed in 1963 by Dr. William Mustard at the Hospital for Sick Children in Toronto, Ontario, Canada. Dr. Mustard, with support from the Heart and Stroke Foundation of Canada, developed an alternative and simplified technique to the Senning procedure which was used to correct a congenital heart defect that produced “ blue babies”. The technique was adopted by other surgeons and became the standard operation for d-TGA. In his autobiography, South African cardiac surgeon Christiaan Barnard claims to have been the first to perform the operation, with Mustard only following 'several years later'. Background The defect is called transposition of the great vessels, or transposition of the great arteries (TGV or TGA). Until the late 1950s, and Senning's operation, the condition was commonly fatal. The defect causes blood from the lungs to flow back to the lungs and blood from the body to flow back to the body. This occurs because the aorta and the pul ...
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Jatene Procedure
Arterial switch operation (ASO) or arterial switch, is an open heart surgical procedure used to correct dextro-transposition of the great arteries (d-TGA). Its development was pioneered by Canadian cardiac surgeon William Mustard and it was named for Brazilian cardiac surgeon Adib Jatene, who was the first to use it successfully. It was the first method of d-TGA repair to be attempted, but the last to be put into regular use because of technological limitations at the time of its conception. Use of the arterial switch is historically preceded by two atrial switch methods: the Senning and Mustard procedures. The atrial switch, which was an attempt to correct the physiology of transposition, had significant shortcomings. The arterial switch sought to address them. This has emerged as an anatomically as well as physiologically appropriate solution.Marathe SP, Talwar S. Surgery for transposition of great arteries: A historical perspective. Ann Pediatr Cardiol. 2015 May-Aug;8(2):1 ...
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Ventricular Septal Defect
A ventricular septal defect (VSD) is a defect in the ventricular septum, the wall dividing the left and right ventricles of the heart. The extent of the opening may vary from pin size to complete absence of the ventricular septum, creating one common ventricle. The ventricular septum consists of an inferior muscular and superior membranous portion and is extensively innervated with conducting cardiomyocytes. The membranous portion, which is close to the atrioventricular node, is most commonly affected in adults and older children in the United States. It is also the type that will most commonly require surgical intervention, comprising over 80% of cases. Membranous ventricular septal defects are more common than muscular ventricular septal defects, and are the most common congenital cardiac anomaly. Signs and symptoms Ventricular septal defect is usually symptomless at birth. It usually manifests a few weeks after birth. VSD is an acyanotic congenital heart defect, aka a lef ...
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