Analysis of Arrhythmias After Correction of Partial Anomalous Pulmonary Venous Connection

Tratamento cirúrgico da conexão anômala parcial das veias pulmonares em veia cava superior

“…Ages ranged from 6 months to 68 years and the rhythm was always sinus at the hospital discharge and in late verification, [5] except for one patient who initially showed junctional rhythm, spontaneously reverted to sinus. There was no use of pacemaker in any patient or need for reoperation.…”

“…Even with this [6] technique and its modification by enlarging the region, the authors describe cases of stenosis or occlusion of superior vena cava especially when the left superior vena cava was persistent [5]. A possible cause of stenosis of the superior vena cava is the need to bring the cephalic stump of superior vena cava up to the right atrial appendage.…”

Lateral Cavoatriotomy for Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

“…Therefore, authors generally recommend the Warden procedure to avoid sinus node dysfunction. 7,8) However in recent series transient sinus node dysfunction 9,10,11) and SVC stenosis 11,12) have been reported after Warden procedure. Park, et al have informed that deep stitches to the sinus node and its artery while reconstructing the pulmonary-venous pathway is the possible mechanism for transient sinus node dysfunction after Warden procedure.…”

“…However, just the incision site might not be the only factor responsible for arrhythmias. 8) Thung, et al 16) and later Nicholson,et al 6) suggested that retraction of the sinus node without vascular injury might also cause postoperative sinus node dysfunction. Moreover, the incision or traction may steadily cause fibrosis in that area, resulting in sinus node dysfunction during the follow-up.…”

“…The authors recommended that an incision through the cavoatrial junction must be avoided to preserve sinus node and its artery. 7,8) Our clinical choice of procedure for PAPVC repair is also lateral cavoatriotomy, including little modifications. The purpose of this retrospective study is to evaluate our experience with this incision technique.…”