scholarly journals The Warden Procedure through a Posterolateral Thoracotomy Approach

2014 ◽  
Vol 41 (5) ◽  
pp. 499-501 ◽  
Author(s):  
Sowmya Ramanan ◽  
Navaneetha Sasikumar ◽  
Soman Rema Krishna Manohar ◽  
Kotturathu Mammen Cherian
Keyword(s):  
Superior Vena Cava ◽  
Septal Defect ◽  
Sinoatrial Node ◽  
Superior Vena ◽  
Vena Cava ◽  
Posterolateral Thoracotomy ◽  
Venous Obstruction ◽  
Venae Cavae ◽  
Anomalous Pulmonary Venous Connection ◽  
Sinoatrial Node Dysfunction

The Warden procedure for the correction of a right-sided partial anomalous pulmonary venous connection to the high superior vena cava is well established. It has the advantages of avoiding sinoatrial node dysfunction and pulmonary and systemic venous obstruction. In the case related here, a 3-year-old girl presented with a superior vena cava type of sinus venosus atrial septal defect and an anomalously draining right upper pulmonary vein, with bilateral superior venae cavae. Our approach to the Warden procedure was through a right posterolateral thoracotomy, which provided additional advantages.

scholarly journals Anomalous right-sided pulmonary venous connection to the superior vena cava

2016 ◽  
Vol 72 (1) ◽  
Author(s):  
Kiumars Abbasi ◽  
Ali Abbasi ◽  
Mokhtar Tazik ◽  
Abbas Salehiomran ◽  
Ali Kazemisaeed ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Superior Vena Cava ◽  
Septal Defect ◽  
Superior Vena ◽  
Vena Cava ◽  
Good Health ◽  
Anomalous Pulmonary Vein ◽  
The Right ◽  
Anomalous Pulmonary Venous Connection

Over the years, different techniques have been introduced for the repair of sinus venosus atrial septal defect (ASD) with anomalous right-sided pulmonary venous connection to the superior vena cava. We report the case of a 9- year-old girl, who presented with dyspnea and peripheral cyanosis. Preoperative echocardiography and angiography findings suggested a partial anomalous pulmonary venous connection. On cardiopulmonary bypass, the ASD was dilated, and the anomalous pulmonary vein was anastomosed to the right atrium and redirected to the left atrium using an intraatrial baffle and a tube graft. The intraoperative and postoperative periods were uneventful, and the patient is currently in good health at 4.5 years’ follow-up.

Superior Vena Cava Flap to Reroute Partial Anomalous Pulmonary Venous Connection

2019 ◽  
Vol 10 (5) ◽  
pp. 645-647
Author(s):  
Ai Sugimoto ◽  
Shuichi Shiraishi ◽  
Masashi Takahashi ◽  
Masanori Tsuchida
Keyword(s):  
Superior Vena Cava ◽  
Septal Defect ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Anterior Wall ◽  
Atrial Septal Defect Closure ◽  
Pulmonary Venous Stenosis ◽  
Anomalous Pulmonary Vein ◽  
Anomalous Pulmonary Venous Connection

A 46-year-old man who had undergone atrial septal defect closure during childhood was referred for surgery for residual partial anomalous pulmonary venous connection. The anomalous pulmonary veins were connected to the higher (cephalad) segment of the superior vena cava. As the usual caval division technique was not applicable, we chose to utilize the anterior wall of the superior vena cava as a flap for anomalous pulmonary vein rerouting. Bovine pericardium was used to reconstruct the systemic venous pathway. Systemic or pulmonary venous stenosis was not detected. The patient was discharged with a sinus rhythm.

scholarly journals Total Anomalous Pulmonary Venous Connection with Lethal Pulmonary Venous Obstruction Managed by Multidisciplinary Cooperation

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Kana Ito ◽  
Ayako Chida-Nagai ◽  
Osamu Sasaki ◽  
Nobuyasu Kato ◽  
Takeshi Umazume ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Caesarean Section ◽  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Superior Vena ◽  
Vena Cava ◽  
Pulmonary Venous Obstruction ◽  
Venous Obstruction ◽  
Anomalous Pulmonary Venous Connection

Background. Total anomalous pulmonary venous connection (TAPVC) is a critical congenital heart disease for which emergency surgery is required after birth. In cases of no intervention, TAPVC is associated with a high mortality rate in the first year of life. Although foetal echocardiographic techniques for diagnosing TAPVC have improved, TAPVC remains one of the most difficult congenital heart diseases to diagnose via foetal echocardiography. Here, we report a case of TAPVC with pulmonary venous obstruction (PVO), which was diagnosed via foetal echocardiography. Case Presentation. On foetal echocardiography at 32 weeks’ gestation, a large atrial septal defect, enlarged superior vena cava, and continuous flow pattern in the vertical vein from the common chamber were observed in the foetus. Paediatric cardiologists and cardiac surgeons, neonatologists, and obstetricians planned to perform a caesarean section and emergency heart surgery. The male infant was born at 37 weeks’ gestation via caesarean section, and postnatal echocardiography revealed PVO at the confluence of the superior vena cava and common chamber. Similarly, chest computed tomography confirmed the foetal diagnosis. The postnatal diagnoses were TAPVC type Ib, PVO, atrial septal defect, and patent ductus arteriosus. Surgical repair of the TAPVC was initiated within the first 3 hours of life. Screening brain echocardiography and head computed tomography revealed intracranial haemorrhage and hydrocephalus. Therefore, the patient underwent emergency bilateral external drainage on day 13. On day 48, a ventriculoperitoneal shunt was inserted owing to progressive brain ventricular dilatation. The patient was discharged home on postoperative day 68. Conclusions. Although the prognosis of TAPVC with PVO remains poor, continuous observation through foetal echocardiography and early interdepartmental collaboration can result in good outcomes.

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

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.

Partial Anomalous Pulmonary Venous Connection: Forty-Six Years of Follow-Up

2021 ◽  
Vol 12 (1) ◽  
pp. 70-75
Author(s):  
Anne Kathrine M. Nielsen ◽  
Vibeke E. Hjortdal
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Sinus Node ◽  
Vena Cava ◽  
Node Disease ◽  
Sinus Node Disease ◽  
Patch Technique ◽  
Anomalous Pulmonary Venous Connection

Background: Surgical repair of partial anomalous pulmonary venous connection (PAPVC) may disturb the electrical conduction in the atria. This study documents long-term outcomes, including the late occurrence of atrial tachyarrhythmia and bradyarrhythmia. Methods: This retrospective study covers all PAPVC operations at Aarhus University Hospital between 1970 and 2010. Outcome measures were arrhythmias, sinus node disease, pacemaker implantation, pathway stenosis (pulmonary vein(s), intra-atrial pathway, and/or superior vena cava), and mortality. Data were collected from databases, surgical protocols, and hospital records until May 2018. Results: A total of 83 patients were included with a postoperative follow-up period up to 46 years. Average age at follow-up was 43 ± 21 years. During follow-up, new-onset atrial fibrillation or atrial flutter appeared in four patients (5%). Sinus node disease was present in nine patients (11%). A permanent pacemaker was implanted in seven patients (8%) at an average of 12.7 years after surgery. Pulmonary venous and/or superior vena cava obstruction was seen in five patients (6%). Stenosis was most prevalent in the two-patch technique, and arrhythmia was most prevalent in the single-patch technique. Sixty-seven (81%) of 83 patients had neither bradyarrhythmias nor tachyarrhythmias or pacemaker need. Conclusions: This study contributes important long-term data concerning the course of patients who have undergone repair of PAPVC. It confirms that PAPVC can be operated with low postoperative morbidity. However, late-onset stenosis, bradyarrhythmias and tachyarrhythmias, and need for pacemaker call for continued follow-up.

scholarly journals P649 Before and after: sinus venosus atrial septal defect

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Marco Clement ◽  
R Eiros ◽  
R Dalmau ◽  
T Lopez ◽  
G Guzman ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Left Atrium ◽  
Atrial Flutter ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Septal Defect ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
The Right

Abstract Introduction The diagnosis of sinus venosus atrial septal defect (SVASD) is complex and requires special imaging. Surgery is the conventional treatment; however, transcatheter repair may become an attractive option. Case report A 60 year-old woman was admitted to the cardiology department with several episodes of paroxysmal atrial flutter, atrial fibrillation and atrioventricular nodal reentrant tachycardia. She reported a 10-year history of occasional palpitations which had not been studied. A transthoracic echocardiography revealed severe right ventricle dilatation and moderate dysfunction. Right volume overload appeared to be secondary to a superior SVASD with partial anomalous pulmonary venous drainage. A transesophageal echocardiography confirmed the diagnosis revealing a large SVASD of 16x12 mm (Figure A) with left-right shunt (Qp/Qs 2,2) and two right pulmonary veins draining into the right superior vena cava. Additionally, it demonstrated coronary sinus dilatation secondary to persistent left superior vena cava. CMR and cardiac CT showed right superior and middle pulmonary veins draining into the right superior vena cava 18 mm above the septal defect (Figures B and C). After discussion in clinical session, a percutaneous approach was planned to correct the septal defect and anomalous pulmonary drainage. For this purpose, anatomical data obtained from CMR and CT was needed to plan the procedure. During the intervention two stents graft were deployed in the right superior vena cava. The distal stent was flared at the septal defect level so as to occlude it while redirecting the anomalous pulmonary venous flow to the left atrium (Figure D). Control CT confirmed the complete occlusion of the SVASD without residual communication from pulmonary veins to the right superior vena cava or the right atrium (Figure E). Anomalous right superior and middle pulmonary veins drained into the left atrium below the stents. Transthoracic echocardiographies showed progressive reduction of right atrium and ventricle dilatation. The patient also underwent successful ablation of atrial flutter and intranodal tachycardia. She is currently asymptomatic, without dyspnea or arrhythmic recurrences. Conclusions In this case, multimodality imaging played a key role in every stage of the clinical process. First, it provided the diagnosis and enabled an accurate understanding of the patient’s anatomy, particularly of the anomalous pulmonary venous connections. Secondly, it allowed a transcatheter approach by supplying essential information to guide the procedure. Finally, it assessed the effectiveness of the intervention and the improvement in cardiac hemodynamics during follow-up. Abstract P649 Figure.

An Alternative Approach for a High Partially Anomalous Pulmonary Venous Connection to the Superior Vena Cava: “A Drawbridge Technique”

2022 ◽  
pp. 215013512110702
Author(s):  
Roman Sekelyk ◽  
Dmytro Kozhokar ◽  
Vsevolod Safonov ◽  
Illya Yemets
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Alternative Technique ◽  
Alternative Approach ◽  
Anomalous Pulmonary Venous Connection

We present an alternative technique for the repair of a high partially anomalous pulmonary venous connection to the superior vena cava.

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