To the content
3, Приложение . 2021

Supracardiac partial anomalous pulmonary venous connection: double-patch or Warden techniques?

Abstract

Aim. This study evaluates the outcomes of partial anomalous pulmonary venous connection to the superior vena cava using double-patch correction and the Warden technique. In particular, the development of complications such as sinus node dysfunction and PV and SVC stenosis.

Material and methods. During the research, 110 publications were analyzed for the period from 1984 to 2020; then, fourteen materials were selected that provide the best answer to the question raised. The information obtained: authors, publication date, patient group, surgeries, complications were summarized in the table.

Results. In the early postoperative period, sinus node dysfunction was observed in the range from 9.6 to 55% of cases after double-patch correction and from 0 to 7.1% after the Warden procedure. At follow-up, sinus node dysfunction persisted in 5-9.6% of patients after double-patch correction and 0-5% of patients after the Warden procedure. Moderate SVC stenosis (requiring no correction) was observed in 0-8% of patients after a double-patch technique, and in 0-16.6% after the Warden procedure. Severe SVC stenosis (requiring correction) was observed in 10 cases among all patients after the Warden procedure, in 1 case after a double-patch technique. A moderate increase in the pulmonary venous gradient was noted in both groups and was represented by isolated cases. 

Conclusions. The considered options for the correction of PAPVC to SVC showed satisfactory outcomes. The incidence rate of sinus node dysfunction was significantly lower in the Warden group. The risk of SVC stenosis was lower in the group after double-patch correction.

Keywords:Warden procedure, partial anomalous pulmonary venous connection, doublepatch

FundingThe study had no sponsor support.
Conflict of interestThe authors declare no conflict of interest.
For citationGorbatikov K.V., Totolin I.S., Zykova E.Yu., Novoselova L.G., Karpov E.A., Chezganova N.I. Supracardiac partial anomalous pulmonary venous connection: double-patch or warden techniques? Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (3). Supplement: 71-6. DOI: https://doi.org/10.33029/2308-1198-2021-9-3suppl-71-76 (in Russian) 

References 

1. Vyaznikov V.A., Dynnik I.B., Chebotar’ E.V., et al. Long-term results of heart and vascular surgery: collection of scientific papers. In: I.K. Okhotin (ed.). Gorky: GMI, 1996: 101–11. (in Russian)

2. Korolev B.A., Vyaznikov V.A., Rybinsky A.D. Reoperations for defects of the interventricular septum. In: Reconstructive Surgery: Collection of scientific papers of the All-Union Scientific Center of Surgery: GMI named after C.M. Kirov. Moscow, 1981. 15-6. (in Russian)

3. Serraf A., Belli E., Roux D., et al. Modified superior approach for repair of supracardiac and mixed total anomalous pulmonary venous drainage. Ann Thorac Surg. 1998; 65 (5): 1391-3.

4.    Brody H. Drainage of pulmonary veins into the right side of the heart. Arch Pathol. 1942; 33: 221-40.

5.    Sharykin A.C., Levchenko E.G. Classification of hereditary diseases in pediatric cardiological practice. Byulleten’ NTsSSKh imeni A.N. Bakuleva RAMN. [Bulletin of the Scientific Center of Cardiovascular Surgery named after A.N. Bakulev RAMS]. 2001; (3): 149. (in Russian)

6.    Tan R.B., Cuaso C.C., Hiyao С., et al. A rare anatomic variant: partial anomalous pulmonary venous connection of the right pulmonary veins to an aneurysmal left vertical vein. Ann Thorac Surg. 2014; 97 (3): 1083. DOI: https://doi.org/10.1016/j.athoracsur.2013.08.068

7.    Svyazov E.A. Comparative analysis of long-term results of correction of partial abnormal drainage of the right upper pulmonary veins into the superior vena cava. Sibirskiy meditsinskiy zhurnal [Siberian Medical Journal]. 2017; 32 (1): 78-82. (in Russian)

8.    Zubritskiy A., et al. Outcomes of Double-patch and Warden Techniques in Patients with Supracardiac Partial Anomalous Pulmonary Venous Connection. Heart Lung Circ. 2019; 29 (1): 156-61.

9.    Warden H.E., Gustafson R.A., Tarnay T.J., Neal W.A. An Alternative method for repair of partial anomalous pulmonary venous connection to the superior vena cava. Ann Thorac Surg. 1984; 38 (6): 601-5.

10.    Agarwal V., Okonta K.E., Abubakar U., Gichuhi S. Impact of Warden’s procedure on the sinus rhythm: our experience. Heart Lung Circ. 2011; 20: 718-21.

11.    Alsoufi B., Cai S., Van Arsdell G.S., Williams W.G., Caldarone C.A., Coles J.G. Outcomes after surgical treatment of children with partial anomalous pulmonary venous connection. Ann Thorac Surg. 2007; 84: 2020-6.

12.    DiBardino D.J., McKenzie E.D., Heinle J.S., Su J.T., Fraser C.D. Jr. The Warden procedure for partially anomalous pulmonary venous connection to the superior caval vein. Cardiol Young. 2004; 14: 64-7.

13.    Hongyuan Lin, Jun Yan, Qiang Wang, Shoujun Li, Haining Sun, Yajuan Zhang, et al. Outcomes of the Warden Procedure for Partial Anomalous Pulmonary Venous Drainage. Pediatr Cardiol. 2020; 41: 134-40.

14.    Jie Hu, Renjie Hu, Haibo Zhang, Lei Zhang, Wen Zhang, Dian Chen, et al. Outcomes of Surgical Repair of Partial Anomalous Pulmonary Venous Connection to SVC. Thorac Cardiovasc Surg. 2020; 68 (1): 24-9.

15.    Kottayil B.P., Dharan B.S., Menon S., Bijulal S., Neema P.K., Gopalakrishnan S.K., et al. Anomalous pulmonary venous connection to superior vena cava: Warden technique. Eur J Cardiothorac Surg. 2011; 39: 388-91.

16.    Park C.S., Kwak J.G., Lee C., Lee C.H., Lee S.Y., Choi E.Y., et al. Partial anomalous pulmonary venous connection to the superior vena cava: the outcome after the Warden procedure. Eur J Cardiothorac Surg. 2012; 41: 261-5.

17.    Stewart R.D., Bailliard F., Kelle A.M., Backer C.L., Young L., Mavroudis C. Evolving Surgical Strategy for Sinus Venosus Atrial Septal Defect: Effect on Sinus Node Function and Late Venous Obstruction. Ann Thorac Surg. 2007; 84: 1651-55.

18.    Said S.M., Burkhart H.M., Dearani J.A., Eidem B., Stensrud P., Phillips S.D., et al. Outcome of caval division techniques for partial anomalous pulmonary venous connections to the superior vena cava. Ann Thorac Surg. 2011; 92: 980-4.

19.    Shahriari A., Rodefeld M.D., Turrentine M.W., Brown J.W. Caval division technique for sinus venosus atrial septal defect with partial anomalous pulmonary venous connection. Ann Thorac Surg. 2006; 81: 224-9.

20.    Stephens E.H., Monge M.C., Eltayeb O., Patel A., Webster G., Cornicelli M.D., et al. Evolution and Current Results of a Unified Strategy for Sinus Venosus Surgery. Ann Thorac Surg. 2021; 111 (3): 980-6.

21.    Yong M.S., Griffiths S., Robertson T., Brink J., d’Udekem Y., Brizard C., et al. Outcomes of the Warden procedure for partial anomalous pulmonary venous drainage in children. Interact Cardiovasc Thorac Surg. 2018; 27: 422-6.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

Journals of «GEOTAR-Media»