Deringing procedure for congenital pulmonary vein stenosis

We operated on a 14-year-old boy who had an echocardiographic diagnosis of ventricular septal defect. At surgery we found, in addition, an anomalous and obstructive intraventricular muscle bundle. Detection of a continuous thrill over the right pulmonary veins, prior to cardiopulmonary bypass, led to exploration of the left atrium. The ostia of the right superior and inferior pulmonary veins were impeded by circumferential membranous rings of endocardium with central stenotic openings. Excision of these annular rings relieved the obstruction. The left lung was drained by a long intrapericardial common venous channel that entered the left atrium through a stenotic ostium; excision of an annular ridge of endocardium restored normal flow. The patient remains asymptomatic after 23 months. The case is reported for the new deringing technique and the rarity of successful correction of congenital pulmonary vein stenosis.