Tratamento cirúrgico da estenose do túnel das veias pulmonares após Senning modificado

Abstract

A 13-year-old male was admitted to undergoing correction of a pulmonary venous baffle stenosis (PVBS) after a modified Senning procedure was performed by the age of five months. Recurrent Pulmonary congestion and pneumonia episodes were followed by echocardiography and cardiac catheterization that confirmed PVBS. Previous catheter balloon angioplasty was attempted, and a surgical revision was done under cardiopulmonary bypass. The bovine pericardial patch used for augmentation of the right atrium, retracted and calcified producing PVBS.

Hybrid Stenting of Pulmonary Venous Baffle Stenosis

“…Previous therapeutic options have included open surgical relief of the obstruction or catheter balloon dilation. 6 Additionally, there has been one previous report of a hybrid approach using surgical access for catheter placement, but the authors gained catheter access through a thoracotomy instead of by subxiphoid approach. 7 There has otherwise been no exploration of therapeutic options for patients in which neither a solely surgical or transcatheter approach is both safe and efficacious, nor on other hybrid approaches.…”

Pulmonary venous baffle obstruction following senning procedure - Role of transesophageal echocardiography

“…[ 9 ] The incidence of pulmonary venous baffle stenosis (PVBS) post-Senning procedure is 1.9--7.6%. [ 10 ] Reoperation in the Senning is required in 9--30% of cases in which majority of them are due to the obstruction in the systemic or pulmonary venous baffle. The PVBS can develop due to narrowed baffle, scarred tissue, calcification, or by retraction of the right atrium.…”

“…The PVBS can develop due to narrowed baffle, scarred tissue, calcification, or by retraction of the right atrium. [ 10 ] It can be managed either by the transcatheter balloon dilatation or by surgical intervention. [ 4 ] In our case, PVBS was present at 1 cm anterior to the opening of the lower pulmonary vein and was surgically corrected.…”