Surgery for Partial Anomalous Pulmonary Venous Connections: Modification of the Warden Procedure with a Right Atrial Appendage Flap.
- Author:
Chilsung KIM
1
;
Yang Hyun CHO
;
Mina LEE
;
Ji Hyuk YANG
;
Tae Gook JUN
;
Jin Young SONG
;
June HUH
;
I Seok KANG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. tg.jun@samsung.com
- Publication Type:Original Article
- Keywords:
Congenital heart disease (CHD);
Partial anomalous pulmonary venous connection (PAPVC);
Modified Warden procedure
- MeSH:
Arrhythmias, Cardiac;
Atrial Appendage*;
Follow-Up Studies;
Heart Septal Defects, Atrial;
Humans;
Reoperation;
Sick Sinus Syndrome;
Vena Cava, Superior
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2014;47(2):94-99
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Surgical repair of a partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) may be complicated by sinus node dysfunction or SVC obstruction. We modified the Warden procedure by using a right atrial auricular flap to decrease the occurrence of these complications. METHODS: Between February 2005 and July 2012, 10 consecutive patients underwent a modified Warden procedure to correct PAPVC. The median patient age was 5.7 years. Eight patients (80%) had an atrial septal defect. To surgically correct the PAPVC, we made a U-shaped incision on the right atrial appendage and sutured the flap to the posterior wall of the SVC. The anterior wall was reconstructed with various patch materials. RESULTS: No early or late deaths occurred, nor did any patient require early or late reoperation for SVC or pulmonary venous obstruction. No new arrhythmias appeared during follow-up, which was complete in all patients (mean, 29.5 months). CONCLUSION: Our modification of the Warden procedure seems to be effective and safe. This technique may lower the risk of SVC obstruction, pulmonary venous obstruction, and sinus dysfunction.
