Document Detail

Partial anomalous pulmonary venous connection to the superior vena cava.
MedLine Citation:
PMID:  16928519     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Repair of partial anomalous pulmonary venous connection (PAPVC) to the high portion of the superior vena cava (SVC) may be complicated by atrial arrhythmia and obstruction of the pulmonary veins or SVC. We reviewed our experience with the modified Warden technique, in which the SVC was transected and anastomosed to the right atrial appendage with anterior augmentation of pedicled autologous pericardial flap, and the atrial septum was directly displaced to the SVC orifice. METHODS: Twenty of 51 patients with PAPVC underwent this technique. Mean age was 11.9 years. Follow-up averaged 6.5 years. To quantify the height of insertion of anomalous pulmonary veins, the distance between the highest anomalous pulmonary venous orifice and SVC-right atrial junction was indexed by thoracic vertebral body height (height index). RESULTS: All patients are alive in sinus rhythm. No patients exhibited pulmonary venous obstruction, and mean flow was 0.61 mL. Mean flow of SVC return was 0.79 mL. The SVC occlusion occurred in 2 patients who had persistent left SVC with a good communicating vein. Three patients whose height index exceeded 2.5 successfully underwent catheter intervention at the SVC channel. CONCLUSIONS: Midterm results with the modified Warden technique were satisfactory. Patients with particularly high insertion of anomalous pulmonary veins should be treated and followed with specific caution for preserving an unobstructed caval pathway.
Atsushi Nakahira; Toshikatsu Yagihara; Koji Kagisaki; Ikuo Hagino; Toru Ishizaka; Masahiro Koh; Hideki Uemura; Soichiro Kitamura
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  82     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-24     Completed Date:  2006-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  978-82     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
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MeSH Terms
Anastomosis, Surgical
Atrial Appendage / surgery
Bradycardia / etiology,  therapy
Cardiac Pacing, Artificial
Cardiopulmonary Bypass
Child, Preschool
Follow-Up Studies
Heart Septal Defects, Atrial / surgery
Heart Septum / surgery
Postoperative Complications / etiology,  therapy
Pulmonary Circulation
Pulmonary Veins / abnormalities*,  surgery
Retrospective Studies
Surgical Flaps
Treatment Outcome
Vena Cava, Superior / abnormalities*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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