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Ann Thorac Surg 1996;62:951
© 1996 The Society of Thoracic Surgeons

Correspondence

Coronary Sinus Size as a Determinant of Outcome in Cardiac TAPVC

Anil Bhan, MCh, Anita Saxena, MD, Rajesh Sharma, MCh, Panangipalli Venugopal, MCh

Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029, India

To the Editor:

Jenkins and associates [1] observed that the size of pulmonary veins in patients with infantile totally anomalous pulmonary venous connection determined the outcome with or without surgical repair. We encountered a 2-month-old child with mixed pulmonary venous drainage with three veins draining into the coronary sinus and one vein (left upper lobe vein) draining into the vertical vein system. This patient had two ventricular septal defects: one was in a perimembranous location and one was apical. At operation we found an unexpectedly small coronary sinus. In spite of an attempted complete deroofing the size of the anastomosis was not satisfactory. We closed the perimembranous ventricular septal defect and left the apical ventricular septal defect open, hoping it would decompress the right side in case of any hypertensive crisis. This patient had paroxysmal episodes of pulmonary arterial hypertension in the postoperative period and succumbed to it. We believe that in addition to the size of individual pulmonary veins, the size of the coronary sinus in cardiac totally anomalous pulmonary venous connection could be a predictor of outcome.

Reference

  1. Jenkins KJ, Sanders SP, Coleman L, Mayer JE, Colan SD. Pulmonary vein size and outcome in infants with totally amomalous pulmonary venous connection [Abstract]. Circulation 1991;84(Suppl 2):351.




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