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Long-term results of the Warden procedure for right partial anomalous pulmonary venous connection
Clément Dubost1, Carine Pavy1, Pierre Maminirina1
1Medical-Surgical Department of Pediatric and Congenital Cardiology, Pediatric and Adult Congenital Cardiac Surgery, Hospital for Children and Adolescents, 7 quai Moncousu, 44093NantesCedex 1, France.
Introduction:
Surgery is considered as the first-line therapeutic strategy of partial anomalous pulmonary venous connection. The Warden technique has very good short-term results. The aim of this study is to evaluate the stability of these good results over a long period of follow-up.
Materials And Methods:
We reviewed all patients who underwent a Warden procedure for partial anomalous pulmonary venous connection between 1997 and 2017 in our centre. A total of 73 patients were included. The median age was 14 years (5 months-72 years). Post-operative data were obtained through our hospital network. Late follow-up data were obtained through referrals, cardiologist letters and directly from the patient.
Results:
The mean length of follow-up was 8 years and the longest time was 22 years (range, 1-22). Twenty-five percent of our cohort had more than 10 years of follow-up. There were no cardio-vascular deaths. Eight (11.6%) patients suffered from post-operative rhythm disturbances, 5 (7.2%) of which were permanent. Two (2.9%) patients required a pacemaker implantation. At the end of the follow-up period, only one patient remained pacemaker dependent. There were no pulmonary vein obstructions. Two (2.9%) caval vein stenosis were detected, one at 7 months and the other at 7 years. These patients were treated by angioplasty alone. Five (6.8%) patients were lost to follow-up.
Conclusions:
The good short-term results of the Warden procedure for right partial anomalous pulmonary venous connection appear to persist in the long term, with excellent freedom from pulmonary and caval stenosis in adolescence through to adulthood.
