A Wide Comparison of Techniques for Repair of PAPVCs: One Institution's 20-Year Experience

Jaschinski, Christoph; Cussigh, Christiane S.; Fonseca, Elizabeth; Bruckner, Tom; Kretzler, Matthias; Loukanov, Tsvetomir

doi:10.1055/s-0039-1693655

Cited by 9 publications

(11 citation statements)

References 28 publications

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“…25 Buz et al 3 reported that extended incision across the cavoatrial junction during double-patch repair leads to significant higher rate of postoperative arrhythmias both at discharge and 1-year follow-up. Recently, Jaschinski et al 26 reported double-patch repair had statistically significant higher incidence of persistent arrhythmia (44%, p ¼ 0.035). In accordance with our result, although insignificant, the incidence of SND was higher in group B despite careful cavoatrial incision and adequate patch designing.…”

Section: Discussionmentioning

confidence: 97%

Midterm Outcomes of Surgical Repair of Partial Anomalous Pulmonary Venous Connection to SVC

Zhang

et al. 2019

Thorac cardiovasc Surg

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Objectives We explore midterm results after surgical treatment of partial anomalous pulmonary venous connection (PAPVC) to superior vena cava (SVC) in our institution. Methods From 2008 to 2017, 78 patients underwent surgical repair for PAPVC to SVC. Patients were divided into three groups based on surgical techniques: Single-patch repair (n = 20, group A), double-patch repair (n = 31, group B), and Warden repair (n = 27, group C). Their median age was 1.9 years (range: 3 months–13.8 years); median weight was 11.4 kg (range: 4.4–39.7 kg). Clinical, electrocardiographic and echocardiographic were available for all patients. Results There were no early or late mortality. The mean follow-up duration was 1.8 ± 2.1 years (range: 0.6 months to 8 years). No pulmonary venous obstruction occurred and no residual left-to-right shunts sustained during the follow-up. Reoperation for SVC obstruction was required: 1 (5.3%) in group A, 1 (3.2%) in group B, and 2 (7.4%) in group C (p = 0.78). Four patients (3 in group B, 1 in group C, p = 0.7) presented transient rhythm disturbance at discharge and one patient in group B remains nonsinus rhythm during follow-up. Pacemaker was not required in all patients. Conclusion PAPVC to SVC can be safely managed by multiple techniques. Careful manipulation nearby sinus node must be emphasized during double-patch repair to prevent injury of sinus node. Obstruction of postoperative SVC stenosis should be paid attention to after Warden procedure. For young patients, operation should not be performed that early, but until preschool age.

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Section: Discussionmentioning

confidence: 97%

Midterm Outcomes of Surgical Repair of Partial Anomalous Pulmonary Venous Connection to SVC

Zhang

et al. 2019

Thorac cardiovasc Surg

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“…Stewart et al (13) showed a 55% incidence of supraventricular arrhythmias in the double-patch group, compared to significant lower incidence in singlepatch and Warden groups (24% and 0%, respectively). Similarly, a recent paper by Jaschinski et al (14) displayed analogous features, where patients treated with the double-patch technique had a significantly higher incidence of non-sinus rhythm.…”

Section: Discussionmentioning

confidence: 65%

The impact of the superior cavo-atrial incision in children and adults.

Ait-Alì¹,

Ravaglioli²,

Festa³

et al. 2020

Preprint

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Background and aim of the study The single-and double-patch repairs are the most commonly used techniques for the surgical management of partial anomalous pulmonary venous connection associated with sinus venosus atrial septal defect. The aim of this study was to retrospectively compare early and long-term surgical outcomes in pediatric and adult patients, focusing in particular on the occurrence of postoperative rhythm disturbances. Methods 115 patients (male: 63, 54.8%) underwent surgical repair for partial anomalous pulmonary venous connection with sinus venosus atrial septal defect. 80 patients (70.4%) underwent surgical repair in pediatric age (<16 years old), while 35 (29.6%) patients were operated in adulthood. 49 patients (42.6%) underwent single-patch repair and 65 patients (56.5%) underwent double-patch repair. In only one patient the Warden procedure was performed (0,9%). Median follow-up time was 52 months (IQ 15.1-113). Results The type of surgical technique didn't affect the overall incidence of all rhythm disturbances (41% in single patch group and 35% in double patch groups, p=0.5). At long-term follow-up, ectopic atrial rhythm, as expression of sinoatrial node disturbance, was however significantly more frequent in the pediatric population (32% pediatric group and 8% adult group, p=0.02). Conclusions The higher incidence of ectopic atrial rhythm in children is probably related to the closer relationship of the sinus node to the superior cavo-atrial incision, which makes iatrogenic traumatism more likely to occur. Surgical techniques that avoid any manipulation on the superior cavo-atrial junction should therefore be preferred for children undergoing partial anomalous pulmonary venous connection repair. The impact of the superior cavo-atrial incision in children and adults.

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“…Stewart et al 13 showed a 55% incidence of supraventricular arrhythmias in the double-patch group, compared to significant lower incidence in single-patch and Warden groups (24 and 0%, respectively). Similarly, a recent paper by Jaschinski et al 14 displayed analogous features, where patients treated with the double-patch technique had a significantly higher incidence of non-sinus rhythm.…”

Section: Discussionmentioning

confidence: 65%

The different surgical impact of the superior cavoatrial incision in children and adults

et al. 2020

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Introduction: The single- and double-patch repairs are undoubtedly the most commonly used techniques for the surgical management of partial anomalous pulmonary venous connection associated with sinus venosus atrial septal defect. The aim of this study was to retrospectively compare early and long-term surgical outcomes in paediatric and adult patients, focusing in particular on the occurrence of ectopic atrial rhythm. Material and methods: Seventy patients (male: 38, 54.2%) underwent surgical repair for partial anomalous pulmonary venous connection with sinus venosus atrial septal defect. Forty-nine patients (70%) underwent surgical repair in paediatric age (<16 years old), while 21 of (30%) patients were operated in adulthood. Thirty patients (42.8%) underwent single-patch repair and 39 patients (55.7%) underwent double-patch repair. In only one patient, the Warden procedure was performed (1.4%). Median follow-up time was 52 months (IQ 15.1–113). Results: The type of surgical technique didn’t affect the incidence of ectopic atrial rhythm (26.6% in single-patch group and 25.6% in double-patch groups, p = 0.9). At long-term follow-up, ectopic atrial rhythm, as an expression of sinoatrial node disturbance, was however significantly more frequent in the paediatric population (28.8% paediatric group and 4.7% adult group, p = 0.02). Conclusions: The higher incidence of ectopic atrial rhythm in children is probably related to the closer position of the sinus node to the superior cavoatrial incision, which makes irreversible iatrogenic traumatism more likely to occur. Surgical techniques that avoid any manipulation on the superior cavoatrial junction should, therefore, be preferred for children undergoing partial anomalous pulmonary venous connection repair.

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A Wide Comparison of Techniques for Repair of PAPVCs: One Institution's 20-Year Experience

Cited by 9 publications

References 28 publications

Midterm Outcomes of Surgical Repair of Partial Anomalous Pulmonary Venous Connection to SVC

Midterm Outcomes of Surgical Repair of Partial Anomalous Pulmonary Venous Connection to SVC

The impact of the superior cavo-atrial incision in children and adults.

The different surgical impact of the superior cavoatrial incision in children and adults

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