Lateral Cavoatriotomy for Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

Abstract

Purpose: Surgical correction of the partial anomalous pulmonary venous connection (PAPVC) draining into the superior vena cava (SVC) has been associated with sinus node dysfunction and venous return obstruction, postoperatively. We present the results of our lateral cavoatriotomy approach with little modifications to avoid injury to the sinus node and its artery.
Methods: 32 patients who underwent surgical repair of PAPVC to SVC with modified lateral cavoatriotomy in our clinic between January 2003 and January 2009 were evaluated retrospectively.
Results: Median age was 6 years (2-32 years). The mean follow-up time was 65.8 ± 23.7 months (36-111 months). There were no early or late deaths. No patients required reoperation. New onset of arrhythmia had developed in two patients and resolved before hospital discharge. Stenosis of the SVC in one patient had developed 11 months after the operation and was treated with balloon angioplasty, successfully. No sinus node dysfunction or venous return obstruction was detected in their last follow-up.
Conclusion: Cavoatrial incision for repair of PAPVC to SVC may become a safer surgical technique with some modifications.