Single-patch, 2-patch, and caval division techniques for repair of partial anomalous pulmonary venous connections: Does it matter?

Sameh M. Said, Harold M. Burkhart, Hartzell V Schaff, Frank Cetta, Sabrina D. Phillips, Roxann D. Barnes, Zhuo Li, Joseph A. Dearani

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: We reviewed our experience with the single-patch, 2-patch, and caval division techniques for repair of a partial anomalous pulmonary venous connection. Methods: From 1990 to 2009, 124 patients (65 male patients; 52%) were identified. The single-patch, two-patch, and caval division technique was used in 60 (49%), 24 (19%), and 40 (32%) patients, respectively. The median age was 34.5 years (range, 1-76). Of the 124 patients, 99 (80%) had an atrial septal defect. Results: There was no early mortality. Survival at 5, 10, and 15 years was 99%, 95%, and 82%, respectively. One patient (3%) in the caval division group required early reoperation for superior vena caval obstruction. All patients, exept for 3, had regained sinus rhythm at discharge. Late superior vena caval obstruction developed in 3 patients (7.5%) in the caval division group, 3 (5%) in the single-patch group, and 1 (4%) in the 2-patch group ( = .5). Two patients underwent reoperation for late pulmonary vein obstruction: 1 (2%) in the single-patch group and 1 (4%) in the 2-patch group (P = .08). A permanent pacemaker was required in 3 patients (3%). Conclusions: Surgical treatment of partial anomalous pulmonary venous connections is associated with excellent outcomes. The overall incidence of late superior vena caval or pulmonary vein stenosis is low. Although not significant, the 2-patch technique might be associated with a greater incidence of sinus node dysfunction and late pulmonary venous stenosis. The late development of superior vena caval obstruction is a concern with all techniques, necessitating close follow-up.

Original languageEnglish (US)
Pages (from-to)896-901
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume143
Issue number4
DOIs
StatePublished - Apr 2012

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Venae Cavae
Lung
Reoperation
Sick Sinus Syndrome
Pulmonary Valve Stenosis
Atrial Heart Septal Defects
Pulmonary Veins
Incidence
Survival
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Single-patch, 2-patch, and caval division techniques for repair of partial anomalous pulmonary venous connections : Does it matter? / Said, Sameh M.; Burkhart, Harold M.; Schaff, Hartzell V; Cetta, Frank; Phillips, Sabrina D.; Barnes, Roxann D.; Li, Zhuo; Dearani, Joseph A.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 143, No. 4, 04.2012, p. 896-901.

Research output: Contribution to journalArticle

Said, Sameh M. ; Burkhart, Harold M. ; Schaff, Hartzell V ; Cetta, Frank ; Phillips, Sabrina D. ; Barnes, Roxann D. ; Li, Zhuo ; Dearani, Joseph A. / Single-patch, 2-patch, and caval division techniques for repair of partial anomalous pulmonary venous connections : Does it matter?. In: Journal of Thoracic and Cardiovascular Surgery. 2012 ; Vol. 143, No. 4. pp. 896-901.
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abstract = "Objective: We reviewed our experience with the single-patch, 2-patch, and caval division techniques for repair of a partial anomalous pulmonary venous connection. Methods: From 1990 to 2009, 124 patients (65 male patients; 52{\%}) were identified. The single-patch, two-patch, and caval division technique was used in 60 (49{\%}), 24 (19{\%}), and 40 (32{\%}) patients, respectively. The median age was 34.5 years (range, 1-76). Of the 124 patients, 99 (80{\%}) had an atrial septal defect. Results: There was no early mortality. Survival at 5, 10, and 15 years was 99{\%}, 95{\%}, and 82{\%}, respectively. One patient (3{\%}) in the caval division group required early reoperation for superior vena caval obstruction. All patients, exept for 3, had regained sinus rhythm at discharge. Late superior vena caval obstruction developed in 3 patients (7.5{\%}) in the caval division group, 3 (5{\%}) in the single-patch group, and 1 (4{\%}) in the 2-patch group ( = .5). Two patients underwent reoperation for late pulmonary vein obstruction: 1 (2{\%}) in the single-patch group and 1 (4{\%}) in the 2-patch group (P = .08). A permanent pacemaker was required in 3 patients (3{\%}). Conclusions: Surgical treatment of partial anomalous pulmonary venous connections is associated with excellent outcomes. The overall incidence of late superior vena caval or pulmonary vein stenosis is low. Although not significant, the 2-patch technique might be associated with a greater incidence of sinus node dysfunction and late pulmonary venous stenosis. The late development of superior vena caval obstruction is a concern with all techniques, necessitating close follow-up.",
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AU - Cetta, Frank

AU - Phillips, Sabrina D.

AU - Barnes, Roxann D.

AU - Li, Zhuo

AU - Dearani, Joseph A.

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N2 - Objective: We reviewed our experience with the single-patch, 2-patch, and caval division techniques for repair of a partial anomalous pulmonary venous connection. Methods: From 1990 to 2009, 124 patients (65 male patients; 52%) were identified. The single-patch, two-patch, and caval division technique was used in 60 (49%), 24 (19%), and 40 (32%) patients, respectively. The median age was 34.5 years (range, 1-76). Of the 124 patients, 99 (80%) had an atrial septal defect. Results: There was no early mortality. Survival at 5, 10, and 15 years was 99%, 95%, and 82%, respectively. One patient (3%) in the caval division group required early reoperation for superior vena caval obstruction. All patients, exept for 3, had regained sinus rhythm at discharge. Late superior vena caval obstruction developed in 3 patients (7.5%) in the caval division group, 3 (5%) in the single-patch group, and 1 (4%) in the 2-patch group ( = .5). Two patients underwent reoperation for late pulmonary vein obstruction: 1 (2%) in the single-patch group and 1 (4%) in the 2-patch group (P = .08). A permanent pacemaker was required in 3 patients (3%). Conclusions: Surgical treatment of partial anomalous pulmonary venous connections is associated with excellent outcomes. The overall incidence of late superior vena caval or pulmonary vein stenosis is low. Although not significant, the 2-patch technique might be associated with a greater incidence of sinus node dysfunction and late pulmonary venous stenosis. The late development of superior vena caval obstruction is a concern with all techniques, necessitating close follow-up.

AB - Objective: We reviewed our experience with the single-patch, 2-patch, and caval division techniques for repair of a partial anomalous pulmonary venous connection. Methods: From 1990 to 2009, 124 patients (65 male patients; 52%) were identified. The single-patch, two-patch, and caval division technique was used in 60 (49%), 24 (19%), and 40 (32%) patients, respectively. The median age was 34.5 years (range, 1-76). Of the 124 patients, 99 (80%) had an atrial septal defect. Results: There was no early mortality. Survival at 5, 10, and 15 years was 99%, 95%, and 82%, respectively. One patient (3%) in the caval division group required early reoperation for superior vena caval obstruction. All patients, exept for 3, had regained sinus rhythm at discharge. Late superior vena caval obstruction developed in 3 patients (7.5%) in the caval division group, 3 (5%) in the single-patch group, and 1 (4%) in the 2-patch group ( = .5). Two patients underwent reoperation for late pulmonary vein obstruction: 1 (2%) in the single-patch group and 1 (4%) in the 2-patch group (P = .08). A permanent pacemaker was required in 3 patients (3%). Conclusions: Surgical treatment of partial anomalous pulmonary venous connections is associated with excellent outcomes. The overall incidence of late superior vena caval or pulmonary vein stenosis is low. Although not significant, the 2-patch technique might be associated with a greater incidence of sinus node dysfunction and late pulmonary venous stenosis. The late development of superior vena caval obstruction is a concern with all techniques, necessitating close follow-up.

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