HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Joseph A. Dearani Rakesh M. Suri Gordon K. Danielson Permission Requests Google Scholar Articles by ElBardissi, A. W. Articles by Danielson, G. K. PubMed Articles by ElBardissi, A. W. Articles by Danielson, G. K. Related Collections Congenital - acyanotic

---

Original Articles: Cardiovascular

Left-Sided Partial Anomalous Pulmonary Venous Connections

^a Harvard School of Public Health, Boston, Massachusetts
^b Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minnesota

Accepted for publication November 12, 2007.

^_* Address correspondence to Dr Dearani, Division of Cardiovascular Surgery, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905 (Email: dearani.joseph{at}mayo.edu).

Background: Left-sided partial anomalous pulmonary venous connection (PAPVC) is a congenital defect where pulmonary veins from the left lung drain into the right atrium. If left untreated, PAPVC may result in severe right ventricular failure and pulmonary vascular disease. We sought to determine the effectiveness and long-term outcome after surgical correction of this anomaly.

Methods: From 1954 to 2006, 376 patients were treated at our institution for PAPVC. Of these, 27 (7.1%) patients underwent surgical repair for left-sided PAPVC. Thirteen patients were treated with a minimally invasive approach and 14 were treated with median sternotomy and cardiopulmonary bypass (CPB).

Results: Mean age at time of operation was 33 ± 18 years. Eleven patients had complete left-sided PAPVCs; patients with one anomalous vein had a significantly higher right ventricular systolic pressure (RVSP) than those with two (31 vs 42 mm Hg, p = 0.003). There was a trend toward early surgical treatment in patients with two anomalous veins (27.5 vs 34.6 years, p = 0.14). Patients who underwent off-pump correction were younger (p = 0.04), presented later in our surgical experience (p = 0.004), and had more tricuspid regurgitation (TR) (p = 0.04). Repair of left-sided PAPVC was performed by left thoracotomy without CPB in 13 patients. There were no early or late deaths. Three patients were rehospitalized for cardiovascular reasons during the follow-up period. All patients had right-sided chamber reduction at follow-up, decreased RVSP (p = 0.02), and decreased TR (p = 0.04). Patients who presented with higher grades of TR showed evidence of pulmonary vascular disease at follow-up (p = 0.017).

Conclusions: Repair of PAPVC can be completed successfully with low morbidity. Patients with left-sided PAPVC, right-sided chamber enlargement, evidence of TR, or clinical symptoms should undergo surgical repair.