title: In situ pericardium repair of pulmonary venous obstruction after repair of total anomalous pulmonary venous connection.
abstract: A 13-month-old boy with recurrent pulmonary venous obstruction (PVO) after repair of total anomalous pulmonary venous connection (TAPVC, Darling IIa + Ia) was treated successfully with in situ pericardium repair consisting of unroofing coronary sinus at 2 months. At 8 months, stenosis of the right upper and lower pulmonary veins (PV) and left lower PV were detected, and PVO was relieved via resection of the stenosis site and recutback. Echocardiography 3 months later showed obstructed bilateral PVs and connection between left PVs and vertical veins. At reoperation, we conducted in situ pericardium repair for right PVO and anastomosed left PVs to the left atrial appendage. The postoperative course was satisfactory. Echocardiography 12 months later showed no evidence of PVO, but cardiac catheterization 12 months later showed mild obstruction on the right side and normal venous drainage on the left. Although the long-term prognosis is unknown, this sutureless technique is effective in recurrent PVO.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Osaka City General Hospital, 2-13-22 Miyakojima Hondori, Miyakojima-ku, Osaka 534-0021, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishi
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Nishigaki
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kume
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Miyamoto
mesh_terms: D006801:Humans; D007223:Infant; D008297:Male; D010496:Pericardium; D011667:Pulmonary Veins / Q000002:abnormalities*; D011668:Pulmonary Veno-Occlusive Disease / Q000601:surgery*; D012086:Reoperation