Mid- to long-term surgical outcomes of partial anomalous pulmonary venous connection

Objective To investigate mid- to long-term morbidity and mortality after the repair of partial anomalous pulmonary venous connections (PAPVCs). Methods We retrospectively analyzed the cases of 29 consecutive patients who underwent surgery in 1991–2010 at Tokyo Women's Medical University Hospital. Median follow-up period: 9.9 years. Median age at operation: 7.4 years. Median body weight: 22.4 kg. Right PAPVC ( n = 23), left-PAPVC ( n = 5), and mixed PAPVC ( n = 1) were identified. Results In the 14 patients with a right upper pulmonary vein (PV) connected to the superior vena cava (SVC) and/or cavo-atrial junction, the following were performed: single-patch diversion ( n = 6), double-patch diversion ( n = 4), Warden procedure ( n = 1), and atrial septation with the atrial wall ( n = 3). In the nine patients with a right anomalous PV connected to the right atrium (RA) and/or coronary sinus, intra-atrial rerouting was performed ( n = 7) and translocation of the atrial septum ( n = 2). Intra-atrial rerouting of the left upper and lower PVs to the coronary sinus ( n = 1) and direct anastomosis of the left upper PV to the left atrial appendage ( n = 4) were performed. Double-patch diversion and direct anastomosis of the left upper PV to the left atrial appendage was performed in a patient with mixed PAPVC. There were no post-operative deaths or reoperations, although transient sinus node dysfunction occurred ( n = 2 with atrial septation and intra-atrial rerouting), while mild stenosis of the SVC occurred ( n = 1 with double-patch diversion). Conclusions The various methods which we used for PAPVC repair all appear to have reasonable outcomes, although rhythm disturbance and stenotic complications were confirmed in a few patients.