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Late results following repair of partial anomalous pulmonary venous connection with sinus venosus atrial septal defect

1980; Elsevier BV; Volume: 79; Issue: 5 Linguagem: Inglês

10.1016/s0022-5223(19)37898-5

1097-685X

George A. Trusler, G. Kazenelson, Robert M. Freedom, William G. Williams, Richard D. Rowe,

Vascular anomalies and interventions

The repair of partial anomalous pulmonary venous connection (PAPVC) with sinus venosus atrial septal defect (ASD), long considered a safe and effective procedure, has been reported recently to result in late complications. To determine whether these complications were sufficient to justify some change in technique, we undertook a comprehensive noninvasive assessment of 29 children 2 to 14 years after repair. Eighteen of the children also had a cardiac catheterization. The results were excellent with few complications. Four patients had mild symptoms. There was trivial to slight superior vena caval (SVC) narrowing in eight children, but only one child had a significant SVC-right atrial pressure gradient (6 mm Hg). There were no residual right-to-left shunts, but small left-to-right shunts were found in the SVC of four children. Thirteen children had minor electrocardiographic abnormalities either at rest or during Holter monitoring or exercise testing, but sinus node recovery times were normal in all 12 children tested. Right ventricular enlargement and diminished contractility were identified frequently by echocardiography or angiocardiography. We conclude that a simple patch method of repair of this anomaly is safe and effective. Although this review indicates the importance of certain technical details, we see no reason to change the basic operation. The persistent changes in right ventricular size and contractility appear unrelated to the repair, but part of the primary malformation and further study will be necessary to understand their significance.