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Comparison of different approaches applied for surgical correction of partial anomalous pulmonary venous connection

Published online by Cambridge University Press:  27 February 2025

Fan Fan ,
Song Bai Open the ORCID record for Song Bai [Opens in a new window] ,
Xiaofeng Li ,
Zhiqiang Li ,
Feng Tong Open the ORCID record for Feng Tong [Opens in a new window] ,
Jian Guo ,
Nan Ding Open the ORCID record for Nan Ding [Opens in a new window]  and
Zhangke Guo
Fan Fan
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
Song Bai*
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
Xiaofeng Li
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
Zhiqiang Li
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
Feng Tong
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
Jian Guo
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
Nan Ding
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
Zhangke Guo
Affiliation:
Pediatric Cardiac Center, Beijing Children’s Hospital & Capital Medical University, Beijing, China
*
Corresponding author: Song Bai; Email: [email protected]
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Abstract

Background:

Right anterolateral thoracotomy or left anterolateral thoracotomy applied to partial anomalous pulmonary venous connection correction have been reported to obtain cosmetic and less invasive outcomes as alternative approaches to median sternotomy. However, the application of different approaches is still confusing. We compared the perioperative and mid-term outcomes to seek indications of different approaches and guide surgical treatment of partial anomalous pulmonary venous connection.

Methods:

From July 2019 to August 2023, 44 patients who underwent surgical correction of partial anomalous pulmonary venous connection were recruited. Of these, 13 (29.6%) patients who underwent median sternotomy were separated into M group, 28 (63.6%) patients who underwent right anterolateral thoracotomy were separated into R group, and three (6.8%) patients who underwent left anterolateral thoracotomy were separated into L group. Clinical data were reviewed and compared between each group.

Results:

In M group, direct anastomosis accounted for the most (7, 53.8%), in R group, intra-atrial rerouting accounted for the most (22, 78.6%), and in L group, direct anastomosis accounted for the most (3, 100%). R group had shorter cardiopulmonary bypass time (70.0 ± 32.4 vs113.1 ± 83.3, p = 0.029), shorter ICU stay (1.0 ± 0.2 vs 1.9 ± 1.7, p = 0.01), shorter postoperative stay (6.0 ± 1.2 vs 8.3 ± 5.0, p = 0.021), and fewer chest tube drainage (8.4 ± 4.3 vs 13.9 ± 10.2, p = 0.026) compared with M group. Three left-sided partial anomalous pulmonary venous connection in L group adopted off-pump approach.

Conclusions:

Median sternotomy S.V.C. can be applicable to all anatomic types of partial anomalous pulmonary venous connection especially for complex types. Considering the minimally invasive advantages, we prefer applying right anterolateral thoracotomy for pulmonary vein connected to right atrium or proximal end of off-pump. Applying left anterolateral thoracotomy for left-sided partial anomalous pulmonary venous connection without atrial septal defect by off-pump.

Keywords

partial anomalous pulmonary venous connectionCHDminimally invasive approachlateral thoracotomycardiac surgery
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 8
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

Dillman, JR, Yarram, SG, Hernandez, RJ. Imaging of pulmonary venous developmental anomalies[J]. AJR Am J Roentgenol 2009; 192 ( 5 ): 1272–1285.CrossRefGoogle ScholarPubMed
Nicholson, IA, Chard, RB, Nunn, GR, Cartmill, TB. Transcaval repair of the sinus venosus syndrome[J]. J Thorac Cardiovasc Surg 2000; 119 ( 4 ): 741–744.CrossRefGoogle ScholarPubMed
ElBardissi, AW, Dearani, JA, Suri, RM, Danielson, GK. Left-sided partial anomalous pulmonary venous connections[J]. The Annals of thoracic surgery 2008; 85 ( 3 ): 1007–1014.CrossRefGoogle ScholarPubMed
Dodge-Khatami, J, Noor, R, Riggs, KW, Dodge-Khatami, A. Mini right axillary thoracotomy for congenital heart defect repair can become a safe surgical routine[J] 2022; 1–4.CrossRefGoogle Scholar
Mathis, L, Crethers, D, Buckman, B, Jensen, M, Polimenakos, AC. Partial anomalous pulmonary venous connection repair. Customized Approach and Outcomes[J] 2021; 42: 1064–1073.Google ScholarPubMed
Amirghofran, AA, Nirooei, E, Edraki, M. Minimally invasive versus sternotomy approach for double-patch repair of partial anomalous pulmonary venous connection and sinus venosus defect in pediatric and adult patients: mid to long-term outcomes[J] 2022, 37:4808–4815.CrossRefGoogle Scholar
Dodge-Khatami, J, Dodge-Khatami, A. Advantages of a mini right axillary thoracotomy for congenital heart defect repair in children[J] 2022, 32:276–281.CrossRefGoogle Scholar
Liu, YL, Zhang, HJ, Sun, HS, Li, SJ, Su, JW, Yu, CT. Correction of cardiac defects through a right thoracotomy in children[J]. J Thorac Cardiovasc Surg 1998; 116 ( 2 ): 359–361.Google ScholarPubMed
Van Meter, C jr, LeBlanc, JG, Culpepper, WS 3rd and Ochsner, JL. Partial anomalous pulmonary venous return[J]. Circulation 1990; 82: Iv195–8.Google ScholarPubMed
Murphy, JG, Gersh, BJ, M., D, McGoon, et al. Long-term outcome after surgical repair of isolated atrial septal defect. Follow-up at 27 to 32 years[J]. N Engl J Med 1990; 323 ( 24 ): 1645–1650.CrossRefGoogle ScholarPubMed
Shah, AH, Oechslin, E, Benson, L, et al. Long-term outcomes of unrepaired isolated partial anomalous pulmonary venous connection with an intact atrial septum[J]. Am J Cardiol 2023; 201: 232–238.CrossRefGoogle ScholarPubMed
Said, SM, Ricciardi, G. Repair of partial anomalous pulmonary venous connection to the azygous vein via right thoracotomy[J] 2023, 14:227–230.CrossRefGoogle Scholar
Bozso, SJ, Evans, B, Chu, MWA. Minimally invasive periareolar approach to repair sinus venosus atrial septal defect with partial anomalous pulmonary venous connection[J] 2020, 35:1653–1656.CrossRefGoogle Scholar
Rao, RK, Varadaraju, R, Basappa, G, Nagaraja, PS. Repair of sinus venosus defects with partial anomalous pulmonary venous connection in children by modified right vertical infra axillary thoracotomy[J]. Innovations (Phila) 2019; 14 ( 6 ): 553–557.CrossRefGoogle ScholarPubMed
Javangula, K, Cole, J, Cross, M, Kay, PH. An unusual manifestation of left partial anomalous pulmonary venous connection[J]. Interact Cardiov Th 2010; 11 ( 6 ): 846–847.CrossRefGoogle ScholarPubMed
Ammannaya, GKK, Mishra, P, Khandekar, JV. Left sided PAPVC with intact IAS-surgically managed with vertical vein anastomosis to LA appendage: a rare case report[J]. Int J Surg Case Rep 2019; 59: 217–219.CrossRefGoogle Scholar
Said, SM, Greathouse, KC, McCarthy, CM, Brown, N. Safety and efficacy of right axillary thoracotomy for repair of congenital heart defects in children[J] 2023, 14:47–54.CrossRefGoogle Scholar
Li, G, Su, J, Fan, X, et al. Safety and efficacy of ventricular septal defect repair using a cosmetic shorter right lateral thoracotomy on infants weighing less than 5 kg[J]. Heart Lung Circ 2015; 24 ( 9 ): 898–904.CrossRefGoogle ScholarPubMed
Liu, YL, Zhang, HJ, Sun, HS et al. Repair of cardiac defects through a shorter right lateral thoracotomy in children[J]. Ann Thorac Surg 2000; 70 ( 3 ): 738–741.CrossRefGoogle ScholarPubMed