Endocardial Anchoring Technique for Cardiac Total Anomalous Pulmonary Venous Return

To improve the suboptimal outcomes of the cutback technique for cardiac total anomalous pulmonary venous return, we devised a novel modification for this conventional method that consists of an L-shaped incision of the roof of the coronary sinus into the pulmonary venous confluence, followed by turning over the flap and anchoring it to the endocardium of the left atrium. Our modification provides a large, oval communication between the pulmonary vein confluence and the left atrium and resultant smooth drainage of the pulmonary venous blood, which may prevent turbulent blood flow and the subsequent development of intimal hyperplasia.