A new surgical approach for correction of partial anomalous pulmonary venous drainage into the superior vena cava

Partial Anomalous Pulmonary Venous Connection: Correction by Intra-atrial Baffle and Cavo-atrial Anastomosis

“…This technique, which presented the theoretical advantage of avoiding the mechanical complications of caval obstruction, was nevertheless disappointing in terms of prevention of arrhythmias, as 33% of their patients developed postoperative arrhythmias. 6 Superior vena cava transection with cavo-atrial anastomosis was proposed in order to decrease the development of these complications. The main advantages of this technique are decreased manipulation of the cavo-atrial junction while avoiding the creation of conduits inside the superior vena cava.…”

Isolated Partial Anomalous Pulmonary Venous Connections in Adults: Twenty-Year Experience

“…In the 1972 follow-up study of Friedli and associates of 14 pediatric patients with right-sided PAPVC, significant obstruction of the vena cava was reported in three patients, particularly in those with one anomalous PV draining high into the SVC. 15 In our series, mild baffle stenosis occurred in one patient with anomalous right-sided PV draining into the SVC. One patient with anomalous rightsided PV draining into the azygous vein required two reoperations for baffle obstruction.…”

“…12 Other described techniques include using flaps of atrial tissue or plication of the SVC and right atrium to redirect PAPVC to the left atrium. [13][14][15] In 1983, Warden and colleagues described a technique of caval division and atriocaval anastomosis. 16 Surgical approaches have been described involving median sternotomy with cardiopulmonary bypass or thoracotomy off cardiopulmonary bypass.…”

“…16 Surgical approaches have been described involving median sternotomy with cardiopulmonary bypass or thoracotomy off cardiopulmonary bypass. 3,[11][12][13][14][15][16][17][18][19][20][21] In our review, most of the patients who required surgery had more than one anomalous PV in the context of RV enlargement. This coincides with Brody's observation.…”

“…He later described repair of PAPVC to the SVC with the use of a patch to divert PV flow across the atrial septum into the left atrium 12 . Other described techniques include using flaps of atrial tissue or plication of the SVC and right atrium to redirect PAPVC to the left atrium 13–15 . In 1983, Warden and colleagues described a technique of caval division and atriocaval anastomosis 16 .…”