Modified Warden Procedure Using the Concept of Senning Operation: Repair Without Any Patch

Various surgical techniques have been proposed to repair a partial anomalous pulmonary venous connection to the superior vena cava, such as the single-patch, the double-patch, and the caval division (Warden) techniques. The limited growth potential of the artificial patch, stenosis of the cavoatrial channel or rerouted pulmonary vein channel, and the risk of sinus node dysfunction were possible adverse events. We here describe a modified Warden procedure without any patch in a 6-month-old infant. Using the concept of the Senning atrial switch technique, the interatrial septum and the free wall of the right atrium were used to baffle the anomalous pulmonary vein into the left atrium.