Modified closed chamber sutureless technique for anomalous pulmonary venous connection

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiac Surgery
• Congenital Heart Disease

Background:

• Repair of obstructed total anomalous pulmonary venous connection (TAPVC) often faces visibility challenges.
• Current repair methods frequently necessitate deep hypothermia and low flow bypass, increasing surgical risks.
• Sutureless techniques are gaining traction for primary anomalous pulmonary venous connection repair.

Purpose of the Study:

• To describe a modified sutureless technique for primary repair of obstructed TAPVC.
• To evaluate the feasibility and benefits of a lateral approach for TAPVC repair.
• To demonstrate how this technique can provide a bloodless surgical field and facilitate surgery at mild hypothermia.

Main Methods:

• A modified sutureless technique involving marsupialization of the left atrium around the common pulmonary venous chamber, leaving the right lateral aspect open.
• Utilizing a lateral surgical approach to enhance visualization and minimize cardiac retraction.
• Performing the repair under mild hypothermia.

Main Results:

• The described lateral approach modification of the sutureless technique provides a bloodless surgical field.
• Minimal retraction of the heart is required, facilitating the procedure.
• The technique allows for surgery to be performed at mild hypothermia, potentially reducing complications.

Conclusions:

• This modified sutureless technique offers improved visibility and safety for obstructed TAPVC repair.
• The lateral approach is particularly beneficial for small confluence obstructed TAPVC and mixed TAPVC.
• The technique holds promise for simplifying TAPVC repair and improving patient outcomes.