Korean J Thorac Cardiovasc Surg.  2001 Sep;34(9):672-679.

Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

• Lee S
• Kim WH
• Kang HS
• Bae CH
• Jheon SH
• Kwon OC
• Ahn WS

Abstract

BACKGROUND: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. MATERIAL AND METHOD: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the entrance site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. RESULT: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75+/-4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt.
CONCLUSION
Our current approach is relatively simple and reproducible in achieving unobstructive pulmonary venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

Keyword

Pulmonary vein, partial anomalous return; Vena cava, superior; Anastomosis, surgical

MeSH Terms

Academic Medical Centers
Aged
Anastomosis, Surgical
Arteries
Atrial Appendage
Daegu
Drainage
Echocardiography
Follow-Up Studies
Heart Atria
Hospitals, General
Humans
Incidence
Intraoperative Complications
Lost to Follow-Up
Male
Pulmonary Veins
Replantation
Sick Sinus Syndrome
Sinoatrial Node
Vena Cava, Superior*