Concomitant orthotopic heart transplantation and repair of left partial anomalous pulmonary venous return

We report the technique of concomitant heart transplantation and repair of left partial anomalous pulmonary venous return (PAPVR). The patient was a 64-year-old male with a past medical history significant for non-ischaemic cardiomyopathy and a ventricular septal defect. He developed cardiogenic shock requiring insertion of a surgically implanted microaxial pump. He was listed for heart transplantation. Preoperative computed tomography demonstrated left PAPVR draining into the coronary sinus, with a left superior vena cava and patent innominate vein. At explant, the left PAPVR drained into a dilated coronary sinus continuous with the left atrial cuff. The junction of the left PAPVR to the coronary sinus was unroofed, and the septum was resected to form a common chamber. The caudal side of the coronary sinus was closed from both the left atrium and right atrium. The donor left atrium was anastomosed to the common chamber formed by the coronary sinus and left atrial cuff with a running 3-0 polypropylene suture. The rest of the donor heart anastomoses were performed in a standard fashion. The left SVC was identified outside the pericardial space and ligated. The patient was discharged with normal graft function.