Complete Repair of Total Anomalous Venous Return
Complete repair of a total anomalous pulmonary venous return. Also shown is a primary closure of a patent foramen ovale and patent ductus arteriosus. The patient is placed on cardiopulmonary bypass (CPB) in the standard fashion. The patient is then crash cooled to 20 degrees celsius with ice placed on the head and administration of steroids. Antegrade cardioplegia is then administered. The large confluent vein (vertical vein) is dissected and an arteriotomy is made, a subsequent atriotomy is made in the left atrial appendage. A side to side anastomosis using polypropylene suture in a continuous running fashion. The right atrium is then opened and the patent foramen ovale is closed. The patient was warmed to a satisfactory temperature and once adequate hemostasis was achieved the vertical vein is ligated at its insertion into the innominate vein.
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1. White BR, Ho DY, Faerber JA, et al. Repair of total anomalous pulmonary venous connection: Risk factors for postoperative obstruction. The Annals of Thoracic Surgery. 2019;108(1):122-129. doi:10.1016/j.athoracsur.2019.02.017
2.Shi G, Zhu Z, Chen J, et al. Total anomalous pulmonary venous connection. Circulation. 2017;135(1):48-58. doi:10.1161/circulationaha.116.023889
3. Tucker BL, Lindesmith GG, Stiles QR, Meyer BW. The superior approach for correction of the SUPRACARDIAC type of total anomalous pulmonary venous return. The Annals of Thoracic Surgery. 1976;22(4):374-377. doi:10.1016/s0003-4975(10)64970-3
4. Yanagawa B, Alghamdi AA, Dragulescu A, et al. Primary sutureless repair for “simple” total anomalous pulmonary venous connection: Midterm results in a single institution. The Journal of Thoracic and Cardiovascular Surgery. 2011;141(6):1346-1354. doi:10.1016/j.jtcvs.2010.10.056
5. Cooley DA, Cabello OV, Preciado FM. Repair of total anomalous pulmonary venous return: results after 47 years. Tex Heart Inst J. 2008;35(4):451-453.
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