Long-term results of two different techniques in patients with supracardiac partial anomalous pulmonary venous connection via right thoracotomy approach. A prospective study

Abstract

Aim: This study compared outcomes following the double-patch and Warden procedures for correcting partial anomalous connection of the right pulmonary veins to the superior vena cava via right thoracotomy approach. Material and Methods: Hundred patients, aged <18 years old, and with partial anomalous connection of the right pulmonary veins to the superior vena cava were randomly selected into double-patch method (n=50) and Warden procedure (n=50) groups. The median follow-up was 31.5 (range, 10-45) months. The primary endpoint was sinus node dysfunction at the mid-term follow-up period. Results: No early or late mortality occurred. In the early postoperative period, sinus node dysfunction was observed in 32.4% and 7% of cases after double-patch technique and the Warden procedure, respectively (risk ratio, 6.15; 92% confidence interval, 1.45-26.35; p=0.02). At follow-up, sinus node dysfunction remained in two (5%) patients after double-patch correction. All patients had normal sinus rhythm after the Warden procedure. No early or late pacemaker implantation occurred in either group. No patients had significant pulmonary veins or superior vena cava stenosis. Conclusion: The double-patch technique and Warden procedure both showed best mid - term consequences without mortality. The Warden procedure was linked with less sinus node dysfunction in the early postoperative period than the double-patch technique. There was no significant various differences in sinus node dysfunction at the mid-term follow-up.