A single pericardial patch technique for repair of partial anomalous pulmonary venous drainage associated with sinus venosus atrial septal defect

A technique is described for repair of partial anomalous pulmonary venous drainage associated with sinus venosus atrial septal defect. The procedure, using a single autologous pericardial patch, is able to facilitate both reconstruction of the pulmonary venous channel and enlargement of the superior vena cava. This technique also reduces the incidence of arrhythmias.     

Cor triatriatum dexter with anomalous pulmonary venous drainage and sinus venosus atrial septal defect

The atypical location of a membrane in a case of cor triatriatum dexter prompted successful repair of accompanying anomalies, with in situ use of the membrane. The anatomy is described with a review of the literature.     

Sinus venosus type of atrial septal defect with partial anomalous pulmonary venous return.

This report describes our method of repairing the sinus venosus type of atrial septal defects. The superior vena cava is compartmentatlized by means of a single double-armed suture. Caval catheters are used as temporary internal shunts, and a vertical U-shaped patch is incorporated into the atriotomy suture line. The experiences with 27 cases are presented.     

An operative case of partial anomalous pulmonary venous connection with patent ductus arteriosus and atrial septal defect

The patient was a 28-year-old female who had underwent the operation of the closure of ASD on 7 years old. She administered due to palpitation. Cardiac catheterization revealed PDA, residual ASD, and PAPVC that blood flow from right superior pulmonary vein returned to the high level of SVC (juxsta-inominate vein). Successful repair was performed by intraluminal direct closure for PDA and placing a long patch for ASD and PAPVC.     

Cor triatriatum associated with large atrial septal defect and partial anomalous pulmonary venous return. Case report

A rare variant of cor triatriatum is presented with a large true atrial septal defect and partial anomalous pulmonary venous return into the right atrium. The correct diagnosis was made at the operation and abnormal left atrial septum was excised completely and a new interatrial septum was created with pericardial patch in such a position that the abnormally drained right upper pulmonary vein was left in the left atrium. It was thought to use the abnormal left atrial septum to close the atrial septal defect by excising only the right lateral border of this abnormal septum and resuturing it to the right atrial wall to close the true atrial septal defect. This thought could not be realized because of the small size of this abnormal septum and large size of the atrial septal defect. This technique can be realized in small or medium sized atrial septal defects associated with cor triatriatum.     

A surgical technique for correction of total anomalous pulmonary venous drainage

A technique was employed successfully for correction of total anomalous pulmonary venous drainage into the upper right superior vena cava. A J-shaped right atriotomy was performed; the posterior flap was sutured to the anterior border of a previously enlarged atrial septal defect. The right superior vena cava was divided above the site of drainage of the pulmonary veins, and its proximal opening closed with a suture. The pulmonary venous return was directed to the left atrium in this way. The right atrial-right superior vena caval continuity was then reestablished by an anastomosis between the previously opened right atrial appendage and the distal end of the right superior vena cava. Finally the remaining atriotomy was closed. The azygos vein must be ligated to avoid systemic unsaturation. For correction of anomalous pulmonary venous drainage into the azygos vein with this technique, ligature of the azygos vein must be placed distally to the site of anomalous drainage. Three patients, aged 2 months, 7 years, and 16 years, respectively, with different anatomic types of the anomaly, were successfully operated on with this procedure. Findings displayed from the postoperative hemodynamic, echocardiographic, and clinical evaluation are encouraging, after a follow-up period that ranges from 4 months to 4 years. The advantages of the repair are discussed.     

Successful surgical treatment of total left anomalous pulmonary venous return with intact atrial septum--a case report

A successful repair of total left anomalous pulmonary venous return with intact atrial septum is reported. A 7-year-old girl was admitted for evaluation of cardiac murmur which was first noted at 3 months of age. She had been followed up on suspicion of ASD, without any subjective symptoms. Physical examination on admission revealed a systolic ejection murmur at left sternal border. Chest X-ray showed mild cardiomegaly and increased pulmonary vascularity. ECG showed right axis deviation and incomplete right bundle branch block. Selective pulmonary arteriography delineated anomalous return of all left pulmonary veins to RA via vertical vein, left brachiocephalic vein, and SVC, and documented the absence of an atrial septal defect. Ratio of pulmonary to systemic blood flow was 2.2. Vertical vein was anastomosed to left atrial appendage under cardiopulmonary bypass. Postoperative cardiac catheterization showed no difference of wedge pressure between bilateral PA. The patient is up and well 1 years and 6 months after operation.     

Polysplenia with anomalous pulmonary venous drainage to right atrium caused by atrial septal displacement; report of a case

A 3-year-old girl with polysplenia, atrial septal defect (ASD), and partial anomalous pulmonary venous connection (PAPVC) was admitted to our unit to have total correction. Preoperative three-dimensional computed tomography (3D-CT) and transesophageal echo (TEE) showed that the pulmonary veins were connected with what normally constitutes the posterior wall of the left atrium, but right pulmonary veins became incorporated into the right atrium because of the atrial septal displacement. In the procedure, intracardiac inspection revealed absence of septum secondum and leftward deviation of septum primum. Deviated septum primum was incised at the posterior edge and shifted rightward to incorporate right pulmonary veins into the left atrium. ASD was closed using autologous pericardial patch. This type of PAPVC was rare and preoperative 3D-CT and TEE was quite useful in evaluating unique anatomical characteristics.     

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

Nine children with partial anomalous pulmonary venous drainage into the superior vena cava were operated upon. The technique consisted essentially of partitioning and enlargement of the superior vena cava. The partitioning was done in all but one patient, with a longitudinal suture starting above the highest pulmonary vein directing the pulmonary venous flow through the enlarged atrial septal defect into the left atrium. The anterior cavo-auricular tunnel was enlarged with a right atrial appendage-superior vena cava angioplasty. Follow-up studies were done between 1 and 3 years after surgery. The hemodynamic data were normal in 7 patients. In 8 children, the superior vena cava was unobstructed and its diameter was normal as demonstrated by cavograms. In all patients, the angiographic evaluation of the pulmonary venous return was normal. These results are encouraging and indicate that this new approach is superior to those which have previously been reported.