Endocardial Anchoring Technique for Variant Supracardiac Total Anomalous Pulmonary Venous Return

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Total anomalous pulmonary venous return (TAPVR) is a complex congenital heart defect requiring surgical repair.
• Conventional TAPVR repair techniques can face challenges, particularly with curved pulmonary venous confluence.
• A need exists for innovative surgical modifications to improve TAPVR repair outcomes.

Purpose of the Study:

• To introduce and describe the endocardial anchoring technique, a novel modification for TAPVR repair.
• To evaluate the theoretical advantages of the endocardial anchoring technique, including pathway smoothness and orifice extension.
• To explore the applicability of this technique in a rare variant of supracardiac TAPVR.

Main Methods:

• Creation of an L-shaped flap from the pulmonary venous confluence.
• Anchoring the flap to the endocardium.
• Application of the technique in a case of supracardiac TAPVR with curved confluence.

Main Results:

• The endocardial anchoring technique theoretically creates a wide and smooth internal pathway.
• Traction force from anchoring may help extend the pulmonary venous connection orifice.
• Successful application in a rare TAPVR variant suggests potential efficacy.

Conclusions:

• The endocardial anchoring technique is a promising modification for TAPVR repair.
• This technique may be a valuable alternative, especially for patients with curved pulmonary venous anatomy.
• Further studies are warranted to confirm the long-term benefits and broader applicability of this approach.