[Techniques of correction of partial right abnormal pulmonary venous return associated with atrial septal defect]

Abstract

Many techniques have been described for correcting partial right anomalous pulmonary venous drainage to avoid the possible complications of stenosis of the systemic or pulmonary venous return, residual shunt or arrhythmias. Between 1985 and 1994, 33 patients aged 1 to 69 years underwent repair of this malformation. The anomalous drainage was situated at the cavo-atrial junction or above in 25 cases and to the right atrium in 8 cases. Depending on the level of the drainage of the anomalous pulmonary veins, the size of the superior vena cava, the site of atrial septal defect and the age of the patient, 3 techniques were used: simple tunneling, tunneling with widening of the superior vena cava by a patch, tunneling with section of the superior vena cava and its transposition to the right atrium. There was no hospital mortality. Postoperative echocardiography showed a minimal residual shunt which regressed at the two months control examination. No cases of restriction of the systemic or pulmonary venous return were observed. Six patients developed arrhythmias during the hospital period. At the end of follow-up, all patients were asymptomatic without residual shunts or restriction of venous drainage. Persistent arrhythmias were observed in one case (3%). There were no differences in the results of the three techniques used. By using the most appropriate technique of repair for the anatomical form allows correction of this malformation with the minimal number of postoperative complications.