Repair of Superior Sinus Venosus Atrial Septal Defect Using a Modified Two-Patch Technique

Chawki Elzein, Mubeena Abdulkarim, Umair Abbas, Luca Vricella, Michel Ilbawi

Research output: Contribution to journalArticle

Abstract

Background: Surgical repair of superior sinus venosus atrial septal defect associated with partial anomalous pulmonary venous connection is usually performed with either a two-patch technique or the Warden procedure. However, both techniques can lead to superior vena cava or pulmonary vein stenosis, as well as sinus node dysfunction. To prevent these complications, we have utilized a modified two-patch technique. Methods: Between January 2000 and December 2015, 44 patients underwent modified two-patch repair of superior sinus venosus atrial septal defect associated with partial anomalous pulmonary venous connection at our institution. The technique utilizes the right atrial appendage to patch the superior vena cava and avoid superior vena cava obstruction. Patients’ data were collected from reviewing hospital charts and clinic records. Results: Mean age was 10.3 years (range, 0.68 to 61 years). There was no hospital mortality. Six patients (13.6%) had sinus node dysfunction after surgery. All of them recovered their normal sinus node function at a mean follow-up period of 45.7 months. No superior vena cava or pulmonary vein stenosis was observed at long-term follow-up. Conclusions: A modified two-patch technique is a valid alternative to other methods of superior sinus venosus atrial septal defect and partial anomalous pulmonary venous connection repair, and prevents late systemic/pulmonary venous pathway obstruction while maintaining sinus rhythm.

Original languageEnglish (US)
Pages (from-to)583-587
Number of pages5
JournalAnnals of Thoracic Surgery
Volume109
Issue number2
DOIs
StatePublished - Feb 2020
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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