[Right atrial flap method for repair of partial anomalous pulmonary venous drainage into the high superior vena cava--case report].
We report an alternative method of repairing partial anomalous pulmonary venous return (PAPVR) wherein anomalous veins drain into the high portion of superior vena cava (SVC). A six year old girl, weighing 19 kg underwent cardiac catheterization for cardiomegaly. The study showed sinus venous defect and pulmonary veins anomalously drained from the right upper and middle lobe into the high SVC. Under cardiopulmonary bypass with aortic and bicaval direct cannulation, a 2-cm-wide pedicled flap made from the middle part of the right atrium (RA), was pulled into the SVC. The atrial flap divided the SVC from the ostium of the uppermost pulmonary vein (PV) to the ASD. This posterior tunnel drained anomalous PV blood into the left atrium. Postoperative echocardiogram and magnetic resonance imaging showed adequate space in the SVC and the PV channel. The patient maintained normal sinus rhythm after surgery. The advantage of this method is to minimize the risk of injuring the sinus node or sinus node artery, and to easily reconstruct both the SVC and PV channel without using prosthetic materials, even in patients with small RA.
Matsuo
K
K
Department of Cardiovascular Surgery, Chiba Children's Hospital, Japan.
Suetsugu
F
F
Uchita
S
S
Fujiwara
T
T
Okajima
Y
Y
Aotsuka
H
H
D002648:Child; D005260:Female; D006801:Humans; D008722:Methods; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000601:surgery; D013524:Surgical Flaps; D014683:Vena Cava, Superior / Q000002:abnormalities