Evolving Surgical Strategy for Sinus Venosus Atrial Septal Defect: Effect on Sinus Node Function and Late Venous Obstruction

The outcome of surgical repair of sinus venosus atrial septal defect was reviewed retrospectively. The operation was performed on 44 children aged 8 to 163 months, between April 1985 and November 1998. Median cardiopulmonary bypass and aortic crossclamp times were 58 minutes (range, 29 to 141 minutes) and 29 minutes (range, 4 to 67 minutes), respectively. Use of blood products decreased from 4.5 units per patient in the first period (1985 to 1989) to 0.6 units in the last period (1995 to 1998). Median intensive care and hospital stays were 2 days (range, 1 to 12 days) and 6 days (range, 4 to 16 days), respectively. There was 1 early death (2.3%). Complications included reexploration for bleeding in 2 patients (4.5%) and for superior vena cava obstruction in 1 (2.3%), and arrhythmias in 3 (6.8%), which required a pacemaker in one. During follow-up of 15 to 176 months, 83.8% of patients were in sinus rhythm. One required angioplasty for superior vena cava stenosis, hemodynamically insignificant residual shunt was found in 3, and mild superior vena cava stenosis in 3. Repair of sinus venosus atrial septal defect carries a low mortality and morbidity, but long-term follow-up is needed to monitor potential sinus node dysfunction and superior vena cava stenosis.

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Is double or single patch for sinus venosus atrial septal defect repair the better option in prevention of postoperative venous obstruction?

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivs369 ◽

2012 ◽

Vol 15 (5) ◽

pp. 900-903 ◽

Cited By ~ 4

Author(s):

K. E. Okonta ◽

M. Tamatey

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Sinus Venosus ◽

Venous Obstruction ◽

Defect Repair

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Single-Patch Fold-Back Technique for Augmentation of the Superior Vena Cava in Sinus Venosus Atrial Septal Defect Associated with Partial Anomalous Pulmonary Venous Return

The Heart Surgery Forum ◽

10.1532/hsf98.2014433 ◽

2015 ◽

Vol 17 (6) ◽

pp. 282

Author(s):

Suguru Ohira ◽

Kiyoshi Doi ◽

Takeshi Nakamura ◽

Hitoshi Yaku

Keyword(s):

Atrial Septal Defect ◽

Superior Vena Cava ◽

Septal Defect ◽

Venous Return ◽

Superior Vena ◽

Pulmonary Veins ◽

Vena Cava ◽

Sinus Venosus ◽

Right Atrial ◽

Anomalous Pulmonary Venous Return

Sinus venosus atrial septal defect (ASD) is usually associated with partial anomalous pulmonary venous return (PAPVR) of the right pulmonary veins to the superior vena cava (SVC), or to the SVC-right atrial junction. Standard procedure for repair of this defect is a patch roofing of the sinus venosus ASD and rerouting of pulmonary veins. However, the presence of SVC stenosis is a complication of this technique, and SVC augmentation is necessary in some cases. We present a simple technique for concomitant closure of sinus venosus ASD associated with PAPVR and augmentation of the SVC with a single autologous pericardial patch.

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