[A case of anomalous right pulmonary venous drainage to high segment of superior vena cava with intact atrial septum--surgical repair by cavoatrioplasty avoiding injury to the sinoatrial node and its feeding artery].
Surgical repair of anomalous right pulmonary venous drainage to the high segment of the superior vena cava (SVC) with intact atrial septum in a 5-year-old girl by cavoatrioplasty avoiding injury to the sinoatrial (SA) node and its feeding artery is described. The procedure was composed of #1: an oblique incision at the anterior wall of SVC above the anomalous right pulmonary veins (ARPVs) and closure of the lower end of the SVC, making the lower segment of SVC the ARPV channel, #2: a fan-shaped incision at the base of the right atrial (RA) appendage and suturing the cephalad flap over a created atrial septal defect, diverting the ARPV flow through the SVC into the left atrium, and #3: reconstruction of continuity between the cephalad end of the SVC and the RA by suturing the RA appendage flap over the lower segment of SVC. Pulmonary valvotomy was also done for concomitant pulmonary stenosis. Postoperative course of the patient was excellent, with constant normal sinus rhythm. Angiography one month after operation showed no stenosis of the SVC and pulmonary venous pathways. The method reported here was considered to have following advantages: It employs simple and short incisions, avoids injury to the SA node its feeding artery, and achieves wide and nonobstructive pathways of both SVC and pulmonary venous return without using foreign material.
Aoki
M
M
Department of Cardiovascular Surgery, Saiseikai Shimonoseki Hospital, Japan.
Hayashi
K
K
Sakata
K
K
Kobayashi
Y
Y
Tanimoto
Y
Y
Kito
N
N
D002675:Child, Preschool; D003331:Coronary Vessels; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006346:Heart Septum; D006801:Humans; D011667:Pulmonary Veins / Q000002:abnormalities*; D012849:Sinoatrial Node; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000601:surgery