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.     

部分型肺静脉异位引流至上腔静脉手术矫治方法的改良

目的 为防止部分型肺静脉异位引流至上腔静脉手术矫治后的相关并发症，对其手术方法进行改良。方法 4例患者接受了手术矫治。经右心房至上腔静脉的联合切口，利用上腔一右心房片修补房间隔缺损，同时将右上肺静脉的血流经房间隔缺损引流至左心房，再以一自体心包片加宽上腔静脉同时缝合右心房壁。结果 4例患者全部顺利恢复出院。术后早期超声心动图检查未见肺静脉或腔静脉的梗阻，亦无残余分流。术后随诊患者仍维持窦性心律。结论 该方法操作简单，显露良好，避免了残余分流及肺静脉或腔静脉梗阻的发生，同时避免了窦房结的直接损伤。     

Total anomalous pulmonary venous drainage into the right superior vena cava

An unusual case of total anomalous pulmonary venous drainage (TAPVD) is described with four anomalous veins draining separately into the posterolateral wall of the right superior vena cava (SVC). The defect was successfully reconstructed with a pericardial patch, sutured to the posterior wall of the right SVC, right atrium and the margins of an artificially enlarged inter-atrial communication, thereby directing the pulmonary venous return into the left atrium. The right SVC was reconstructed with a further pericardial patch. Initially autologous pericardium was used, but due to contraction this had to be replaced at a further procedure with heterologous pericardium.     

Left superior vena cava draining into the left atrium, associated with partial anomalous pulmonary venous connection: surgical correction

A persistent left superior vena cava draining into the left atrium may produce a symptomatic right-to-left shunt. Although intra-atrial rerouting techniques, in patients with no connecting vein, have proved to be reliable and successful, in many cases the extracardiac repair is preferable. We report a case of a 5-month-old patient with a not connected left superior vena cava draining into the left atrium, associated with atrial septal defect and partial anomalous pulmonary venous connection. The correction has been achieved by rerouting the pulmonary venous return into the left atrium and by transposition of the left vena cava on the right appendage.     

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.     

A case report of communication of the coronary sinus with both atria associated with persistent left superior vena cava

A 16-year-old Japanese girl with a persistent left superior vena cava draining into the coronary sinus was surgically treated. Both coronary sinus and left superior vena cava were totally unroofed in the posterior wall of the left atrium, but the routes were recognized as a deep ditch. Both preoperative diagnosis and the ensuing successful correction were performed only after the third cardiac catheterization and the third operation, respectively. The importance of preoperative diagnosis and the surgical procedures to correct this anomaly were discussed.     

Rotation-advancement flap method for correction of partial anomalous pulmonary venous drainage into the superior vena cava

Three patients with partial anomalous pulmonary venous drainage into the superior vena cava underwent repair by a rotation-advancement flap method. The technique consisted of atrial partitioning, enlargement of the superior vena cava, and protection of sinus node function. Follow-up studies of all patients were done between 12 and 15 months after the operation. The superior vena cava was not stenosed and its diameter was normal, as demonstrated by cavograms. Pulmonary venous return appeared normal on angiograms, and sinus node function was normal by electrophysiologic studies.     

A case of completely unroofed coronary sinus with persistent left superior vena cava

A 34-year-old female presented with exertional dyspnea. Investigation by echocardiography and cardiac catheterization showed completely unroofed coronary sinus with persistent left superior vena cava (PLSVC) (coronary sinus atrial septal defect, absence of the coronary sinus, and PLSVC-left atrium connection) combined with tricuspid valve regurgitation. Angiocardiography made by injection into the PLSVC demonstrated that the PLSVC was connected to the hemiazygos vein before it drained into the left atrium and the left innominate vein was absent. Although jugular vein pressure rose up to 18 mmHg when the PLSVC was temporarily occluded, it remained unchanged. Therefore, simple ligation of the PLSVC was selected for therapy. Patch closure of the atrial septal defect, tricuspid valve repair, and ligation of the PLSVC was performed successfully.     

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.