SURGICAL TECHNIQUES OF CORRECTION OF PART IAL RIGHT ANOMALOUS PULMONARY VEINOUS DRAINAGE ASSOCIATED WITH ATRIAL SEPTAL-DEFECT

Many techniques have been described for correcting partial right anoma lous pulmonary venous drainage to avoid the possible complications of stenosis of the systemic or pulmonary venous return, residual shunt or arrhythmias. Between 1985 and 1994, 33 patients aged 1 to 69 years un derwent repair of this malformation. The anomalous drainage was situat ed at the cavo-atrial junction or above in 25 cases and to the right a trium in 8 cases. Depending on the level of the drainage of the anomal ous pulmonary veins, the size of the superior vena cava, the site of a trial septal defect and the age of the patient, 3 techniques were used : simple tunneling, tunneling with widening of the superior vena cava by a patch, tunneling with section of the superior vena cava and its t ransposition to the right atrium. There was no hospital mortality. Pos toperative echocardiography showed a minimal residual shunt which regr essed at the two months control examination. No cases of restriction o f the systemic or pulmonary venous return were observed. Six patients developed arrhythmias during the hospital period. At the end of follow -up, all patients were asymptomatic without residual shunts or restric tion of venous drainage. Persistent arrhythmias were observed in one c ase (3%). There were no differences in the results of the three techni ques used. By using the most appropriate technique of repair for the a natomical form allows correction of this malformation with the minimal number of postoperative complications.