Repair of Sinus Venosus Defects With Partial Anomalous Pulmonary Venous Connection in Children by Modified Right Vertical Infra Axillary Thoracotomy

Rao, Rajesh Kishan; Varadaraju, R.; Basappa, Girish; Nagaraja, P S

doi:10.1177/1556984519874800

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…A total of 141 full‐text articles were retained after the screening of titles and abstracts using the exclusion criteria. Full‐text articles were reviewed, and 39 studies meeting the inclusion criteria were included for qualitative and quantitative synthesis 6 , 8 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 (Table 1 ). According to the Newcastle–Ottawa Scale, no study had a low risk of bias, 39 had moderate risk, and 1 had high risk of bias 6 , 8 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , …”

Section: Resultsmentioning

confidence: 99%

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Outcomes Following Surgical Repair of Sinus Venosus Atrial Septal Defects: A Systematic Review and Meta‐Analysis

El‐Andari,

Moolla,

John

et al. 2024

JAHA

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Background Sinus venosus atrial septal defect (SVASD) is a rare congenital cardiac anomaly comprising 5% to 10% of all atrial septal defects. Although surgical closure is the standard treatment for SVASD, data on outcomes have been confined to small cohorts. Thus, we conducted a systematic review of the outcomes of SVASD repair. Methods and Results The primary outcome was death. Secondary outcomes encompassed atrial fibrillation, sinus node dysfunction, pacemaker insertion, cerebrovascular accident, reoperation, residual septal defect, superior vena cava obstruction, and reimplanted pulmonary vein obstruction. Pooled incidences of outcomes were calculated using a random‐effects model. Forty studies involving 1320 patients who underwent SVASD repair were included. The majority were male patients (55.4%), with 88.0% presenting with associated anomalous pulmonary venous connection. The weighted mean age was 18.6±12.5 years, and the overall weighted mean follow‐up period was 8.6±10.4 years. The in‐hospital mortality rate was 0.24%, with a 30‐day mortality rate of 0.5% reported in 780 patients. Incidences of atrial fibrillation, sinus node dysfunction, pacemaker insertion, and cerebrovascular accident over the long‐term follow‐up were 3.3% (2.18%–4.93%), 6.5% (5.09%–8.2%), 2.23% (1.34%–3.57%), and 2.03% (0.89%–2.46%) respectively. Reoperation occurred in 1.36% (0.68%–2.42%) of surgeries, residual septal defect in 1.34% (0.69%–2.42%), superior vena cava obstruction in 1.76% (1.02%–2.9%), and reimplanted pulmonary vein obstruction in 1.4% (0.7%–2.49%). Conclusions This is the first comprehensive analysis of outcomes following surgical repair of SVASD. The findings affirm the safety and effectiveness of surgery, establishing a reference point for evaluating emerging transcatheter therapies. Safety and efficacy profiles comparable to surgical repair are essential for widespread adoption of transcatheter treatments.

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Section: Resultsmentioning

confidence: 99%

“…The Warden procedure and 2‐patch technique are compared in Table S2 . 8 , 13 , 16 , 23 , 34 , 35 , 36 , 45 Rates of sinus node dysfunction, SVC stenosis, pulmonary vein stenosis, and reoperation were compared. The incidence of these outcomes were infrequent in the included studies.…”

Section: Resultsmentioning

confidence: 99%

Outcomes Following Surgical Repair of Sinus Venosus Atrial Septal Defects: A Systematic Review and Meta‐Analysis

El‐Andari,

Moolla,

John

et al. 2024

JAHA

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“…There are few reports on applying minimally invasive cardiac surgery in SV-ASD repair. Most are case reports using minithoracotomy, including (1) posterolateral, 4 (2) anterolateral, 6,11 right vertical axillary thoracotomy, 5,12 and periareolar approach. 13 Meanwhile, there are few reports of totally endoscopic surgery for repairing this anomaly.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Meanwhile, the double-patch technique or the Warden procedure has recently been performed through minithoracotomy in cardiac arrest conditions. [4][5][6] A clinical question that has been raised is whether patients of SV-ASD with APVs draining to the SVC can be repaired safely and effectively through port access. We conducted this study to answer this question.…”

Section: Introductionmentioning

confidence: 99%

Totally Endoscopic Surgery for Repairing Sinus Venosus Atrial Septal Defect Using Double-Patch Technique on Beating Heart

Dang¹,

Nguyen³

2023

Innovations�(Phila)

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Objective: Minimally invasive cardiac surgery has not been widely applied in repairing sinus venosus atrial septal defect (SV-ASD). Most were minithoracotomy using the single-patch technique for patients with anomalous pulmonary veins (APVs) connecting to the superior vena cava–right atrium (SVC-RA) junction. It is unclear whether patients with APVs draining high to the SVC can be repaired safely and effectively through port access. Methods: From May 2019 to October 2022, 11 consecutive SV-ASD patients with APVs connecting high to the SVC were enrolled in this prospective study. One 12 mm port and 2 trocars (5.5 mm and 10 mm) were established. The pleural and pericardial spaces were filled with CO2. The SVC was snared just below the azygos vein. The RA incision was longitudinally extended along the SVC-RA junction to the SVC. The bovine pericardial patches were used to redirect the APV flow to the left atrium through the ASD and to enlarge the SVC and the SVC-RA junction. Results: There were no early or late deaths and no reoperations. The concomitant procedures included 5 patients (45.5%) with patent foramen ovale closure, 2 with ASD extension, and 3 with tricuspid valve repair. No endoscopic failure was recorded. The average cardiopulmonary bypass and operative times were 96 (23) min and 190 (30) min, respectively. No cases of venous stenosis or sinus node dysfunction were noted during follow-up of 16.4 ± 12.2 months. Conclusions: SV-ASD with the APVs draining high to the SVC could be repaired safely and effectively through port access with a double-patch technique.

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“…Rao and colleagues reported this technique in 14 children who underwent repair of sinus venosus ASD and PAPVC. 25 The mean age and weight in their series were 9.5 years and 21 kg, respectively. They used aortic and total peripheral venous cannulation and a double patch technique for repair in all patients.…”

Section: Commentmentioning

confidence: 90%

Safety and Efficacy of Right Axillary Thoracotomy for Repair of Congenital Heart Defects in Children

Said

Greathouse

McCarthy

et al. 2023

World J Pediatr Congenit Heart Surg

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Background Minimally invasive repair of congenital heart defects in children has not gained wide popularity yet compared to minimally invasive approaches in adults. We sought to review our experience with this approach in children. Methods This study included a total of 37 children (24 girls, 64.9%) with a mean age of 6.5 ± 5.1 years, who underwent vertical axillary right minithoracotomy for repair of a variety of congenital heart defects between May 2020 and June 2022. Results The mean weight of these children was 25.66 ± 18.3 kg. Trisomy 21 syndrome was present in 3 patients (8.1%). The most common congenital heart defects that were repaired via this approach were atrial septal defects (secundum in 11 patients, 29.7%; primum in 5, 13.5%; and unroofed coronary sinus in 1, 2.7%). Twelve patients (32.4%) underwent repair of partial anomalous pulmonary venous connections with or without sinus venosus defects, while 4 patients (10.8%) underwent closure of membranous ventricular septal defects. Mitral valve repair, resection of cor triatriatum dexter, epicardial pacemaker placement, and myxoma resection occurred in 1 patient (2.7%) each. No early mortality or reoperations. All patients were extubated in the operating room, and the mean length of hospital stay was 3.3 ± 2.04 days. Follow-up was complete (mean 7 ± 5 months). No late mortality or reoperations. One patient required epicardial pacemaker placement due to sinus node dysfunction 5 months after surgery. Conclusions Vertical axillary right thoracotomy is a cosmetically superior approach that is safe and effective for repair of a variety of congenital heart defects in children.

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Repair of Sinus Venosus Defects With Partial Anomalous Pulmonary Venous Connection in Children by Modified Right Vertical Infra Axillary Thoracotomy

Cited by 5 publications

References 10 publications

Outcomes Following Surgical Repair of Sinus Venosus Atrial Septal Defects: A Systematic Review and Meta‐Analysis

Outcomes Following Surgical Repair of Sinus Venosus Atrial Septal Defects: A Systematic Review and Meta‐Analysis

Totally Endoscopic Surgery for Repairing Sinus Venosus Atrial Septal Defect Using Double-Patch Technique on Beating Heart

Safety and Efficacy of Right Axillary Thoracotomy for Repair of Congenital Heart Defects in Children

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