1915-2000 Biography
Born December 14, 1915 in Rattvik, the son of a physician and educated in Sweden, Ake Senning was a student of Clarence Crafoord in Stockholm. Both were creative innovators and giants of the founding generation of cardiac surgeons that included Lillehei, Kirklin, Gibbon, Bigelow, and Shumway. In common with surgeons of that era, both practiced in many surgical fields. Senning himself trained in orthopedics, neurosurgery, and trauma management. During 1952, Senning became lecturer in experimental surgery in Stockholm. In 1956 he was appointed "Extraordinarius" for surgery and in 1957 was elected Senior Surgeon in the Department of Thoracic Surgery at the Karolinska University. In 1961 he was appointed as Chief of the Department of Surgery at the University of Zurich, Switzerland, the successor of Billroth, Sauerbruch, Kronlein, and the immediate successor of Alfred Brunner. In turn, he was eventually succeeded by his trainee, Marko Turina. At Zurich he conducted surgery in a variety of specialties, including general, vascular, thoracic, and cardiac, and was the last surgeon in Zurich who operated so broadly. During 1964 he began the practice of renal transplantation in Zurich and in 1968 performed the first European cardiac transplantation. In 1981 he corrected the Budd-Chiari Syndrome by relief of the hepatic vein stenosis. At the time of his arrival in Zurich, the local mortality of open heart surgery was over 50% and the upper age eligibility limit was 35 years. Twenty years later the operative mortality was less than 1% and no age limit to surgical eligibility existed.
Crafoord had urged the development of cardiopulmonary bypass, which Senning accomplished by 1952 when he coupled it with hypothermia and achieved experimental survival after bypass of 40 minutes. The following year he added ventricular fibrillation cardiac arrest. In 1954 he removed a left atrial myxoma from a woman during bypass with electrically induced ventricular fibrillation, followed by electrical defibrillation. Both fibrillator and defibrillator were designed and built by his longtime colleague, Rune Elmqvist. The patient remains alive in 2000. In 1955 he resected a large postinfarction left ventricular aneurysm, in 1956 undertook correction of supracardiac total anomalous venous return, and in 1958 invented hemodynamic correction of transposition of the great arteries by atrial switch, the "Senning Operation." In that year he endarterectomized the left anterior descending and left circumflex arteries of a patient with an occluded right coronary artery and severe angina pectoris. Repair was the first with a saphenous vein patch. On October 8, 1958 he implanted, by thoracotomy, an Elmqvist designed and constructed rechargeable cardiac pacemaker, the first such implant, into a 43-year-old patient with complete heart block and syncope. The device failed the same day and a second unit was implanted the following day. That unit too failed within a short time and was removed. Arne Larsson then survived until a third unit was implanted in 1961. In Montevideo, Uruguay, a similar rechargeable pacemaker model was implanted in February 1960, the first successfully implanted cardiac pacemaker.
During his career Ake Senning published 350 articles in thoracic, cardiovascular, and general surgery; renal transplantation; management of vertebral tumors; and renal artery stenosis. As an educator, researcher, and clinician he was widely influential and admired and was the center of a substantial medical-scientific community. He lived and then retired in Zurich, maintaining his ties to Sweden where he continued to vacation throughout his life. He died July 21, 2000, several months before his eighty-fifth birthday.
Corinna Brunckhorst
Reto Candinas
Seymour Furman
Interview Excerpts Senning's background (1:49 sec.; Real Audio)
First clinical work involving extracorporeal circulation (3:38 sec.; Real Audio)
Devising an implantable pacemaker with Rune Elmqvist (2:51 sec.; Real Audio)
First human implantable pacemaker (Arne Larsson)(3:14 sec.; Real Audio)
Why first implants failed (0:26 sec.; Real Audio)
Excerpted from this interview:
Interviewer: Seymour Furman, MD
Date: March 8, 1998
Place: Zurich, Switzerland
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