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Sinus node dysfunction after partial anomalous pulmonary venous connection repair.

Carlo Pace Napoleone1, Elisabetta Mariucci2, Emanuela Angeli1

  • 1Pediatric Cardiac Surgery, S. Orsola-Malpighi Hospital, Bologna Medical School, Bologna, Italy.

The Journal of Thoracic and Cardiovascular Surgery
|September 25, 2013
PubMed
Summary
This summary is machine-generated.

Surgical repair of partial anomalous pulmonary venous connection to the superior vena cava using an internal patch shows good medium-term results. Exercise stress tests are best for detecting asymptomatic sinus node dysfunction.

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Published on: November 18, 2018

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Partial anomalous pulmonary venous connection (PAPVC) to the superior vena cava (SVC) is a congenital heart defect.
  • Surgical repair using an intracardiac patch has raised concerns regarding potential obstruction and sinus node dysfunction.

Purpose of the Study:

  • To review the outcomes of surgical repair for PAPVC to the SVC using an intracardiac patch.
  • To evaluate the incidence of obstruction and sinus node dysfunction after this repair technique.

Main Methods:

  • A review of 59 patients who underwent surgical repair for PAPVC to the SVC between 1991 and 2011.
  • Follow-up included electrocardiogram, echocardiogram, Holter monitoring, and exercise stress testing.

Main Results:

  • No early or late deaths, and no reoperations were reported at a mean follow-up of 46 months.
  • All patients were asymptomatic (New York Heart Association class I).
  • Echocardiography ruled out venous obstruction. Sinus rhythm was present in 93% of patients; however, 18% showed sinus node dysfunction on Holter monitoring, and 30% had chronotropic incompetence on exercise stress testing.

Conclusions:

  • Intracardiac repair of PAPVC to the SVC yields good medium-term results.
  • The rates of sinus node dysfunction and venous obstruction are comparable to other surgical techniques.
  • Exercise stress testing is crucial for identifying asymptomatic sinus node dysfunction.