This video demonstrates a sinus venosus ASD repair with the two patch repair technique.
Authors: Emily Goodman; Brian Reemtsen, MD; Markus Renno, MD; Christian Eisenring, ACNP-BC; Lawrence Greiten, MD
University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR
Arkansas Children’s Hospital, Little Rock, AR
Two Patch Repair Technique
Echocardiographic findings of right atrial and ventricular dilatation
Presence of pulmonary hypertension in infancy/early childhood significantly increases the risk of death or serious complications. In adults (> 40), the surgeon would want to get a hemodynamic cath prior to surgical closure to evaluate for pulmonary artery pressures (<70mmHg ideal) and the pulmonary to systemic flow ratio.
Bicaval cardiopulmonary bypass. It should be noted that SVC cannulation was completed high (far away from SVC RA junction). Paitent was given 10ml/kg of Del Nido cardioplegia solution and kept normothermic throughout the case.
Transthoracic echocardiogram, Cardiac CTA with 3-D reconstruction
Sinus venosus ASD with two anomalous pulmonary veins draining high into the SVC. The right inferior and left pulmonary vein drain normally to the left atrium.
Advantage- Correction of the anomalous pulmonary venous drainage into the left atrium
Disadvantages- risk included below
Injury to the sinus node and post-operative sinus node dysfunction, stenosis/obstruction of SVC, pulmonary veins, or the ASD (if too small, or need to create one when there is an intact atrial septum).
Comprehensive Surgical Management of Congenital Heart Disease – Richard Jonas ISBN: 978-1-4441-1215-3