Early Outcomes for In Situ Pericardial Roll Repair for Distant Anomalous Pulmonary Venous Return

Najm, Hani K.; Ahmad, Mahmood; Salam, Yezan; Klein, Jared; Hasan, Sibah; Majdalany, David; Stewart, Robert D.; Pettersson, Gösta; Karamlou, Tara

doi:10.1016/j.athoracsur.2020.03.063

Cited by 7 publications

(26 citation statements)

References 14 publications

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“…[3][4][5]24,64,92 The risk of postoperative obstruction increases with circular direct anastomoses, acute angulation of veins, the requirement for increased mobilization, and handling or clamping at the time of surgery. [3][4][5]13,58,61,64,89,90 Although the pericardial tunnel, or "sutureless," technique as described by Sun et al 63 addresses several drawbacks that increased risk of pulmonary venous obstruction of other techniques, it is difficult to apply in cases of marked right-sided positioning of the heart, and hypoplasia of the right lung. Lugones et al 61,71 described a modification of their original rerouting technique using the sutureless concept, along with repositioning of the atrial septum.…”

Section: Discussionmentioning

confidence: 99%

“…That this ideal has yet to be achieved is evident from the numerous surgical techniques described, along with follow‐up studies that report an undesirable incidence of postoperative venous or baffle obstruction. Reintervention, either surgical or by catheter, varies from 11% to 30% 19,24,57,58,89,90,92 …”

Section: Discussionmentioning

confidence: 99%

“…A myriad of surgical techniques has been described for managing distant anomalous pulmonary veins, including mobilization and direct implantation into the left atrium, use of interposition grafts, and creation of an intra‐atrial baffle through a pre‐existing or newly constructed atrial septal defect 3–5,24,64,92 . The risk of postoperative obstruction increases with circular direct anastomoses, acute angulation of veins, the requirement for increased mobilization, and handling or clamping at the time of surgery 3–5,13,58,61,64,89,90 …”

Section: Discussionmentioning

confidence: 99%

“…Analysis was based initially on the individualized review of 91 investigations 1–4,6–92 . These were then incorporated from the results of the retrospective study emanating from the multi‐centric European Registry, which itself had collated the findings from 485 patients from 51 institutions, being carried out under the auspices of the Association for European Pediatric Cardiology and the European Congenital Heart Surgeons Association 5,64 …”

Section: Methodsmentioning

confidence: 99%

“…4.4.23 | Transcatheter therapy/surgical ligation of major aortopulmonary collateral arteriesAortopulmonary collateral arteries are managed by either embolization using detachable mini balloon, mini coils, or tissue adhesive or by surgical transthoracic ligation. Balloon angioplasty and balloon-expandable stainless steel Palmaz stent have been employed for stenotic anomalous pulmonary veins [3][4][5]9,13,19,20,[23][24][25][57][58][59][60][61][62][63][64][75][76][77][89][90][91][92].…”

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confidence: 99%

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Surgical management of the scimitar syndrome

Chowdhury

Anderson

Sankhyan

et al. 2021

Journal of Cardiac Surgery

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Background and Aim: We sought to address the varied anatomical details, the diagnostic challenges, associated cardiopulmonary anomalies, the techniques, and outcomes of management, including re-interventions of scimitar syndrome.Methods: A total of 92 published investigations of scimitar syndrome were reviewed. Diagnostic information was provided by clinical presentations, radiographic findings, transthoracic and transesophageal echocardiography, computedtomographic angiography, magnetic resonance imaging, angiocardiography, and ventilation/perfusion scans. These investigations served to elucidate the origin, course, and termination of the scimitar vein, the intracardiac anatomy, the presence of associated defects, and the patterns of any accompanying pulmonary lesions prior to surgical intervention.Results: Of the patients described, up to four-fifths presented during infancy, with cardiac failure, increased pulmonary flow, and pulmonary hypertension. Associated cardiac and extracardiac defects, particularly hypoplasia of the right lung, are present in up to three-quarters of cases. Overall operative mortality has been cited between 4.8% and 5.9%. Mortality was highest in patients with preoperative pulmonary hypertension, and those undergoing surgery in infancy. Despite timely surgical intervention, post-repair obstruction of the scimitar vein, intra-atrial baffle obstruction, or stenosis of the inferior caval vein were reported in up to two-thirds of cases. The venous obstruction could not be related to any particular surgical technique. On long term follow-up, one sixth of patients reported persistent dyspnoea and recurrent respiratory infections.Conclusions: Any infants presenting with heart failure, right-sided heart, and hypoplastic right lung should be evaluated to exclude the syndrome. An increased appreciation of variables will contribute to improved surgical management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Surgical management of the scimitar syndrome

Chowdhury

Anderson

Sankhyan

et al. 2021

Journal of Cardiac Surgery

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Unobstructed infracardiac total anomalous pulmonary venous connection in a 7‐month‐old infant: A rare case report

Shhada,

Nahle,

Hamdar

et al. 2023

Clinical Case Reports

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Key Clinical MessageThis case underscores the importance of early detection and treatment for total anomalous pulmonary venous connection, a rare congenital heart condition, through comprehensive newborn physical exams and prompt specialist referrals.AbstractTotal anomalous pulmonary venous connection (TAPVC) is a rare form of congenital heart disease that is typically diagnosed in neonates. TAPVC has four subtypes, with the infracardiac type at risk of obstruction. TAPVC is usually diagnosed in newborns but can occur in other age groups. In this case, a 7‐month‐old male with recurrent cyanotic episodes was diagnosed with TAPVC of the infracardiac type using computed tomography angiography. The patient underwent successful surgical repair with a favorable postoperative course and was discharged in stable condition, and further follow‐up was not possible beyond 2 months. This case emphasizes the importance of early recognition and management of this condition to prevent the progression of subsequent complications.

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