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Partial anomalous pulmonary venous connection (PAPVC) is a rare entity seen in 0.4-0.7% of the population. The connections are highly variable, requiring an individualized approach to surgical repair. Each repair has potential associated complications.
Retrospective chart review of patients who underwent surgical repair of PAPVC between 2002 and 2012. Early results and long-term surgical outcomes after surgical repair of PAPVC at a moderate sized institution were assessed. A variety of modalities were utilized to diagnose each patient, with ultimate confirmation of diagnosis at surgical intervention.
33 consecutive patients were identified with PAPVC. The anomalously connecting veins were right-sided in 28 patients (85%) and left-sided in 5 patients (15%). The most common type of PAPVC was right PAPVC to the superior vena cava in 17 (51%), followed by right PAPVC into the right atrium in 8 (24%), left PAPVC into the vertical vein in 4 (12%), right PAPVC into the inferior vena cava in 2 (6%, both in patients with Scimitar syndrome), and left PAPVC to a left superior vena cava in 1 (3%) patient. The repair strategy over this period of time included single patch repair in 5 (15%), double patch repair in 14 (42%), Warden procedure in 9 (27%), and direct anastomosis in 5 (15%). There was no early or late mortality. Freedom from further cardiac intervention was 88%. There were 3 (9%) patients who developed superior vena cava obstruction and 2 (6%) required intervention. There was 1 (3%) patient with post-operative pulmonary vein obstruction, which required reoperation. One (3%) patient required cardiac transplantation for restrictive cardiomyopathy, which was diagnosed prior to the PAPVC repair. No patients have required pacemaker implantation.
PAPVC is a rare entity requiring a personalized approach to diagnosis and repair. Contemporary surgical treatment of PAPVC is associated with good outcomes and low morbidity.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Congenital Cardiology Solutions: Surgical Outcomes
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1118-120
- 2013 American College of Cardiology Foundation