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Supracardiac Total Anomalous Pulmonary Venous Connection: The Transaortopulmonary Approach

^a Service des Cardiopathies Congénitales, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
^b Département d'Imagerie Médicale, Scanner, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France

Accepted for publication June 11, 2009.

^_* Address correspondence to Dr Le Bret, Service des Cardiopathies Congénitales, Centre Chirurgical Marie Lannelongue, 133 avenue de la Résistance, Le Plessis Robinson, 92350, France (Email: e.lebret{at}ccml.fr).

We have been confronted with patients in whom classical techniques did not offer optimum exposure to correct supracardiac forms of total anomalous pulmonary venous connection, especially in neonates. Therefore, we present a surgical modification of the superior approach for enhanced exposure as a result of transection of the ascending aorta associated or not with the transection of the pulmonary trunk. The transaortopulmonary approach ensures a perfect exposition without any need to pull on the surrounding structures. Because of the better exposure, most patients do not require circulatory arrest.