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Partial anomalous pulmonary venous connection draining into superior vena cava--two cases reports
1Division of Cardiovascular Surgery, Kaohsiung Medical University Hospital, No. 100, Shin-Chuan 1st Rd. Kaohsiung 807, Taiwan.
The Kaohsiung Journal of Medical Sciences
|March 29, 2001
Summary
Partial anomalous pulmonary venous connection (PAPVC) often accompanies atrial septal defects (ASD). This study highlights two cases where PAPVC was confirmed intraoperatively, emphasizing the importance of surgical approach for complex cases.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Diagnostics
Background:
- Partial anomalous pulmonary venous connection (PAPVC) is a frequent comorbidity in patients diagnosed with atrial septal defect (ASD).
- The incidence of PAPVC is notably higher in ASD patients (10%) compared to the general population (0.7%).
Observation:
- Two cases initially diagnosed with ASD (sinus venosus and secundum types) were investigated.
- One patient with sinus venosus ASD had confirmed PAPVC draining into the superior vena cava (SVC).
- A second patient, suspected of PAPVC due to abnormal shunting during cardiac catheterization, had the condition confirmed intraoperatively.
Findings:
- Both patients were intraoperatively confirmed to have PAPVC draining into the SVC, associated with sinus venosus ASD.
- Diagnostic challenges, including transesophageal echocardiogram failure, complicated the initial assessment of the second patient.
- Surgical intervention revealed coexistent cardiac defects, necessitating a modified surgical approach.
Implications:
- Minimally invasive surgery using a small midline incision is recommended for ASD cases with suspected PAPVC, allowing for easier extension if needed.
- This approach mitigates potential complications associated with traditional submammary incisions for simple ASD.
- The findings underscore the importance of thorough intraoperative assessment for complex congenital heart anomalies.