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Modified Warden Procedure Using the Concept of Senning Operation: Repair Without Any Patch
Chan-Yang Hsu1, En-Ting Wu2, Shyh-Jye Chen3
1Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
The Annals of Thoracic Surgery
|November 3, 2015
Summary
A modified Warden procedure, avoiding artificial patches, successfully repaired anomalous pulmonary venous connection in an infant. This technique reroutes pulmonary veins to the left atrium using the patient
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Partial anomalous pulmonary venous connection to the superior vena cava requires surgical repair.
- Existing techniques like single-patch, double-patch, and Warden procedures carry risks such as limited graft growth and sinus node dysfunction.
Observation:
- A 6-month-old infant with partial anomalous pulmonary venous connection to the superior vena cava was treated.
- A modified Warden procedure, eliminating the need for artificial patches, was employed.
Findings:
- The modified Warden procedure successfully baffled the anomalous pulmonary veins into the left atrium.
- This technique utilized the Senning atrial switch concept, employing the interatrial septum and right atrial free wall.
Implications:
- This patchless approach may mitigate risks associated with artificial materials in pediatric cardiac surgery.
- The technique offers a potentially safer alternative for repairing partial anomalous pulmonary venous connections in infants.
- Further studies are warranted to evaluate long-term outcomes and applicability in a broader pediatric population.
