[Case report of the superior approach for correction of the supracardiac type of total anomalous pulmonary venous drainage (TAPVD) in the neonatal period].
An eleven-day-old newborn with cyanosis and respiratory distress was admitted. Intubation and catecholamine administration had already done. Blood pressure was 80/50 mmHg, heart rate was 160/min. Urine volume was only 7 ml per 4 hours with diuretics. The diagnosis of supracardiac type of TAPVD was done by echo cardiography. Without cardiac catheterization, emergent operation was performed. After median sternotomy, the mobilization of the aorta was done. Under cardiopulmonary bypass the aorta was retracted to the left, the superior vena cava to the right and the common pulmonary venous trunk (CPV) was identified through the transverse sinus. Parallel incision were made in the left atrium and CPV, and extended to the vertical vein. An anastomosis using continuous suture was fashioned. She had a good postoperative course. The superior approach through the transverse sinus affords excellent exposure of the CPV and left atrium in situ in the neonatal period, if the mobilization of the aorta is completed, and the heart is not compressed or displaced. This approach is useful for supracardiac type of TAPVD.
Kuwabara
M
M
Second Department of Surgery, Miyazaki Medical School.
Onitsuka
T
T
Yonezawa
T
T
Nakamura
K
K
Fukushima
Y
Y
Araki
K
K
Uchimura
Y
Y
Oshikawa
M
M
Shibata
K
K
Koga
Y
Y
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008722:Methods; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000601:surgery