PMID- 21158917
OWN - NLM
STAT- MEDLINE
DCOM- 20110607
LR  - 20161125
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 26
IP  - 1
DP  - 2011 Jan
TI  - Outcome of primary repair of infracardiac total anomalous pulmonary venous 
      connection using a right-sided approach to the left atrium.
PG  - 102-6
LID - 10.1111/j.1540-8191.2010.01170.x [doi]
AB  - OBJECTIVE: Pulmonary venous obstruction (PVO), the major postoperative 
      complication in patients with infracardiac total anomalous venous connection 
      (TAPVC), compromises the surgical outcomes of TAPVC repair. Here, we report our 
      experience using a right-sided approach to the left atrium to repair this anomaly 
      variant. METHOD: Eleven patients with infracardiac TAPVC underwent this surgical 
      modification from September 2005 to December 2009. After a medium sternotomy, 
      bicaval venous cannulation was performed for cardiopulmonary bypass (CPB). By 
      adequate exposure of the surgical field, incision of the left atrium was located 
      and anastomosed to the corresponding incision in the pulmonary venous confluence 
      through the right side. Medical records consisting of preoperative and 
      postoperative data were retrospectively reviewed to analyze the efficiency of 
      this strategy. RESULTS: Total correction was achieved in all 11 patients and 
      there were no operative deaths. Postoperative low cardiac output persisted in six 
      patients (54.5%), including five patients with preoperative PVO. No late deaths 
      were noted in a mean follow-up of 26.7 months (range, 1 to 51 months). Both 
      residual atrial shunt and severe anastomotic obstruction were excluded by 
      transthoracic echocardiography. Moderate residual obstruction was confirmed in 
      one patient. At the end of the follow-up, all patients had normal biventricular 
      function and were in New York Heart Association (NYHA) Functional Class I. 
      CONCLUSION: The right-sided approach for repair of infracardiac TAPVC contributes 
      to produce favorable outcomes. This modified technique is useful for enhancing 
      exposure during surgical repair and providing adequate patent anastomosis.
CI  - (c) 2010 Wiley Periodicals, Inc.
FAU - Chen, Hao
AU  - Chen H
AD  - Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School 
      of Medicine, Shanghai Jiao Tong University, Shanghai, China.
FAU - Xu, Zhiwei
AU  - Xu Z
LA  - eng
PT  - Journal Article
DEP - 20101216
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Cardiac Surgical Procedures/*methods
MH  - Echocardiography
MH  - Heart Atria/*surgery
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Scimitar Syndrome/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - Vascular Surgical Procedures/*methods
EDAT- 2010/12/17 06:00
MHDA- 2011/06/08 06:00
CRDT- 2010/12/17 06:00
PHST- 2010/12/17 06:00 [entrez]
PHST- 2010/12/17 06:00 [pubmed]
PHST- 2011/06/08 06:00 [medline]
AID - 10.1111/j.1540-8191.2010.01170.x [doi]
PST - ppublish
SO  - J Card Surg. 2011 Jan;26(1):102-6. doi: 10.1111/j.1540-8191.2010.01170.x. Epub 
      2010 Dec 16.