Repair Of Sinus Venosus Defect Research Articles

Repair of sinus venosus defects with partial anomalous pulmonary venous connection in adult: Four surgical procedures for a large armamentarium

Surgical repair of sinus venosus defects with partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) has been associated with venous return obstructions, and sinus node dysfunction. We aimed to evaluate the safety of four different surgical procedures, for repair of sinus venosus defects with PAPVC, in 23 adult patients, adapted to each patient's specific anatomy assessed by 3D computed tomography. Between March 2010 and May 2019, we performed anatomic repair of sinus venosus defects with a single patch ( n = 6; 26.1%), 2-patch ( n = 9; 39.1%), Warden ( n = 3; 13%), or modified Warden procedure with reconstruction of the divided SVC using a PTFE conduit ( n = 5; 21.7%) ( Fig. 1 ). Median age was 40 years [range, 15 to 73 years]. Main associated procedures were: creation of atrial septal defect ( n = 1), tricuspid valvuloplasty ( n = 2), tricuspid valve replacement ( n = 1), pulmonary valve replacement ( n = 1), monoblock “cut and sew” of pulmonary veins and superior vena cava ( n = 1). Follow-up was 3.26 years [range, 2 months to 10 years]. There were no mortality and no obstruction of SVC and pulmonary veins at the time of discharge and during follow-up. Aortic clamping was shorter (60 ± 39 min) with the single patch technique and longer (112 ± 31 min) with the modified Warden procedure. Nineteen patients (82.6%) had regained sinus rhythm at discharge; a patient with paroxysmal atrial fibrillation had regained a sinus rhythm after the “cut and sew” isolation technique of the superior vena cava and pulmonary veins. All patients were NYHA 1. PAPVC can safely be performed with an appropriate technique, and low morbidity. The single patch technique, when anatomically possible, offers good results but now competes with transcatheter correction. When PAPVC is far from the SVC-right atrium junction, the modified Warden procedure offers an effective and obligatory surgical repair, without any increase in complications.

Silikon Protez Kullanılarak Rekonstrüktif Meme Cerrahisi Uygulanmış Hastada Minimal İnvaziv Sinüs Venozus Defekti Onarımı

Atrial septal defect is one of the most common congenital cardiac anomalies in adulthood. Advances in minimally invasive surgical approaches result in an increased use of these techniques in selected patients. Atrial septal defect closure with minimal invasive surgery through right anterior thoracotomy is one of the first chosen treatment methods with reliable results and high patient satisfaction especially in young ladies. In this paper, we present the repair of sinus venosus defect with minimal invasive methods in a patient whom underwent breast reconstruction using a silicone prosthesis three years ago. The operation through right anterolateral minithoracotomy approach was successful and cosmetically uneventful even in the presence of a complex atrial septal defect and the silicone breast prosthesis in the surgical area

Repair of Sinus Venosus Defects With Partial Anomalous Pulmonary Venous Connection in Children by Modified Right Vertical Infra Axillary Thoracotomy.

To evaluate the safety and reproducibility of modified right vertical infra axillary thoracotomy (RVIAT) for repair of sinus venosus defects with right-sided partial anomalous pulmonary venous connection (PAPVC) in children. Between March 2017 and February 2018, we performed intracardiac repair for sinus venosus defects with right-sided PAPVC in 14 children through modified RVIAT. Median age and weight were 9.5 years and 21 kg, respectively. We modified RVIAT by avoiding central venous cannulation and used total peripheral venous cannulation (right internal jugular vein and right femoral vein). In all children double-patch technique was followed, using untreated autologous pericardium. Intracardiac repair was safely performed in all children. There was no conversion to another approach and there were no complications related to peripheral venous cannulation. All children were in sinus rhythm with no residual defects, with non-obstructive pulmonary venous drainage at the time of discharge and during subsequent follow-ups. Modified RVIAT can be safely performed for repair of sinus venosus defects with right-sided PAPVC, without compromising on the quality of repair. With this modification not only the intracardiac repair was easier, also it provided more working space with minimal rib spreading.

Sinus Venosus Defect and Partial Anomalous Pulmonary Venous Connection: Effect of Surgical Strategies on Sinus Node Function and Potential Obstruction of the Superior Vena Cava

Objectives: Surgical repair of sinus venosus defect (SVD) with partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) or the right atrium (RA) should avoid long term complications like permanent sinus node dysfunction (SND) or obstruction of superior vena cava (SVC). We retrospectively reviewed our single center experience on patients who underwent cardio-surgical repair using single-patch, double-patch and modified Warden-technique.

Percutaneous repair of sinus venosus defect with anomalous pulmonary venous return

We report the first-in-man combined percutaneous repair of a sinus venosus atrial septal defect (SVASD) with anomalous pulmonary venous return (APVR). A 65-year-old woman with increasing exertional dyspnoea was diagnosed by cardiac echocardiography with a 12 × 8 mm SVASD and APVR of the right upper pulmonary vein (RUPV) into the lateral wall of …

A technique of repair of sinus venosus defects without the need of artificial material (surgical movie)

A technique of repair of sinus venosus defects without the need of artificial material (surgical movie)

Age at Repair Affects the Very Long-Term Outcome of Sinus Venosus Defect

Records of patients who had repair of sinus venosus defect (SVD) between 1970 and 2008 were reviewed to predict very long-term outcome. Repairs occurred in 104 consecutive patients (51 men), aged 29 +/- 23 years (range, 1 to 70 years). Seven had isolated SVD and 97 had associated lesions that required concomitant operations. Five patients had preoperative arrhythmias; 24 (23%) were in New York Heart Association (NYHA) class III to V. Single-patch repair was done in 91 patients, caval translocation (Warden) in 7, and double-patch in 6. Ten late deaths during 38 years of follow-up (mean, 15 +/- 20 years). Survival was 97% +/- 2% and 79% +/- 7% at 10 and 30 years. Thirty-one (29%) long-term survivors experienced 47 complications, including chronic/recurrent supraventricular tachycardia in 28, heart failure in 5, permanent pacing in 8, cerebrovascular accident in 3, and unrelated cardiac reoperation in 3. At 30 years, freedom from adverse cardiac events was 47% +/- 9%, from supraventricular tachycardia, 50% +/- 9%; from permanent pacing, 83 +/- 6%; and from cerebrovascular accident, 96% +/- 2%. Follow-up age was 42 +/- 23 years (range, 5 to 82 years); 74 patients (79%) were in NYHA class I, and 15 and 5 were in class II and III to IV, respectively. Baseline cardiac rhythm was sinus in 75 patients (84%), atrial fibrillation in 11 (12%), and paced in 8. Nine patients had moderate/severe pulmonary hypertension, and 8 had left ventricular dysfunction. Only older age at operation was associated with lower survival (p = 0.003), freedom from cardiac events (p = 0.001), supraventricular tachycardia (p = 0.009), and permanent pacing (p = 0.002). Repair before age 20 was associated with lower NYHA class at follow-up (p = 0.01). SVD repair at an older age is associated with increased risk of late mortality, adverse cardiac events, and worse functional outcome. Repair during childhood is strongly advised.

Repair of sinus venosus defect in a patient with untreated vein of Galen aneurysmal malformation

The vein of Galen aneurysmal malformation (VGAM) is a rare cerebral arteriovenous shunt, which may be associated with a congenital cardiac defect. Embolisation of the VGAM may be undertaken in the neonatal period if necessary, but is safer in infancy. Recent advances in neuroradiology have changed the prognosis for this group with many patients achieving survival with normal development. This case report describes a patient with a sinus venosus defect (SVD) and a VGAM and considers both the optimal timing of treatment of the two malformations and the conduct of anaesthesia for open repair of the SVD in the presence of an untreated VGAM.

Robotically assisted repair of sinus venosus defect

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Paucity of sinus node dysfunction following repair of sinus venosus defects in children

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