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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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