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Ann Thorac Surg 1996;61:1293-1294
© 1996 The Society of Thoracic Surgeons

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Correspondence

Transcaval Closure of Sinus Venosus Defect With Butterfly-Shaped Single Patch

The Heart Institute, 15, East St, Kilpauk Garden Colony, Madras 600 010, India

To the Editor:

We read with interest the article on single-patch repair with caval enlargement for sinus venosus defect by Pathi and associates [1]. The technique is very similar to the single-patch repair reported by us [2–5]. We use an oval patch of polytetrafluoroethylene or silk and fold it into two, like the wings of a butterfly. This patch is used as illustrated by Pathi and associates with a few differences. We incise only the cava immediately in front of the anomalous superior pulmonary vein. Atrial extension, which could damage the sinoatrial node or its vascular supply, is unnecessary. Sinus venosus defect is an abnormal confluence of the common cardinal vein, right superior pulmonary vein, and sinus venarum component of the right atrium [5]. We use the posterior flap to separate the superior vena caval and pulmonary venous blood. The ridge between the two flaps is sutured to the posterior lip of the cavotomy externally. We always use the anterior flap to close the cava; this not only enlarges the cava but avoids distortion of the cavoatrial junction, which could contribute to atrial arrhythmias.

References

1. Pathi V, Guererro R, MacArthur KJD, Jamieson MPG, Pollock JCS. Sinus venosus defect: single-patch repair with caval enlargement. Ann Thorac Surg 1995;59:1588–9.[Abstract/Free Full Text]
2. Victor S. Butterfly Gore-Tex patch for repair of sinus venosus ASD [Abstract]. Indian Heart J 1983;35:271.
3. Victor S. Progress in thoracic and cardiovascular surgery. In: Rao MM, ed. Progress in surgery. Madras: The Association of Surgeons of India, 1984:65–8.
4. Victor S. New surgical techniques in congenital heart disease. In: Shetty KR, Parulkar GB, eds. Proceedings of the World Conference on Open Heart Surgery, 1985, Bombay. New Delhi: Tata McGraw-Hill Publishing Co Ltd, 1987:52.
5. Victor S, Nayak VM. Transcaval repair of sinus venosus defect using butterfly shaped patch. Tex Heart Inst J 1995;22:304–7.[Medline]

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Victor, S. Articles by Nayak, V. M. Search for Related Content PubMed PubMed Citation Articles by Victor, S. Articles by Nayak, V. M.