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Caval Division Technique for Sinus Venosus Atrial Septal Defect With Partial Anomalous Pulmonary Venous Connection

Caval Division Technique for Sinus Venosus Atrial Septal Defect With Partial Anomalous Pulmonary Venous Connection,Ali Shahriari,Mark D. Rodefeld,Mark

Caval Division Technique for Sinus Venosus Atrial Septal Defect With Partial Anomalous Pulmonary Venous Connection   (Citations: 9)
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Background. Repair of sinus venosus atrial septal de- fect (ASD) with high partial anomalous pulmonary ve- nous connection (PAPVC) using an internal patch may be complicated by obstruction of the superior vena cava (SVC) or pulmonary veins, or both, and sinus node dysfunction. In cases in which the anomalous veins insert more than 2 cm above the cavoatrial junction, we have adopted the technique of caval division in which the SVC is divided and the proximal end is anastomosed to the right atrial appendage, and the distal SVC serves as a conduit for pulmonary venous drainage to the left atrium through the ASD. We retrospectively compare the results of the internal patch repair versus the Warden technique. Methods. Between 1991 and 2004, 54 patients diagnosed with sinus venosus ASD and PAPVC have undergone repair at our institution. Mean age was 13.4 years (range, 1.5 to 58). Thirteen patients (24%) had high insertion of anomalous veins and underwent the Warden technique. Follow-up averages 4.3 years (range, 1 to 13). Results. There were no early or late deaths. All patients remain in normal sinus rhythm. Twelve of the 13 patients with Warden procedure have had postoperative echocar- diograms, and 11 of these patients showed no evidence of SVC or pulmonary venous obstruction. In 1 patient, symptomatic pulmonary venous obstruction developed and required revision of a contracted intra-atrial pericar- dial baffle. Conclusions. Caval division for treatment of high PAPVC appears to be safe and is associated with low morbidity and mortality. The Warden procedure is an effective surgical option for patients undergoing correc- tion of high PAPVC.
Published in 2010.
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    • ...Shahriari et al. (4) report follow-up after repair of sinus venosus ASDs with partial anomalous pulmonary venous connection...

    Unknown. The year in congenital heart disease

    • ...Most commonly, surgical correction of these lesions is performed using the internal patch technique, or a modification thereof, to redirect the anomalous pulmonary venous return through the sinus venosus defect by baffling these structures with a pericardial or synthetic patch with or without performing a patch cavoplasty as needed [3, 4]. If the insertion of the pulmonary veins is more than 2 cm above the atriocaval junction, the surgeon ...
    • ...Further clinical experiences with this technique or a modified one have been reported by other authors [1, 3, 9, 10]...

    Kiumars Abbasiet al. Anomalous right-sided pulmonary venous connection to the superior vena...

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