Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options - Open Journal of Thoracic Surgery

OJTS > Vol.3 No.4, December 2013

Open Journal of Thoracic Surgery

Volume 3, Issue 4 (December 2013)

ISSN Print: 2164-3059 ISSN Online: 2164-3067

Google-based Impact Factor: 0.29 Citations

Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options ()

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Download as PDF (Size: 172KB) PP. 114-122

DOI: 10.4236/ojts.2013.34024 4,990 Downloads 9,464 Views Citations

Author(s)

Kelechi Emmanuel Okonta, Michael Sanusi

Affiliation(s)

Cardiothoracic Surgery Unit, Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria..
Cardiothoracic Surgery Unit, Department of Surgery, University of Port Harcourt, Rivers State, Nigeria.

ABSTRACT

Background: Superior sinus venosus atrial septal defect (SV-ASD) is an interatrial defect with partial anomalous pulmonary venous connection (PAPVC) draining into the right atrium. The principle for SV-ASD surgical repair involves redirecting the pulmonary venous blood back to the left atrium and closure of the atrial septal defect without compromising the adjoining structures. Methods: We reviewed English literature relating to this topic via a MEDLINE and Google scholar search using the following terms: surgery for sinus venosus atrial septal defect (SV-ASD), surgery for partial anomalous pulmonary venous connection (PAPVC) and complications of the surgery. Results: A total of 910 consecutive cohort patients with different surgical options between 1984 to 2012 were analyzed. The breakdown showed that 291(32.0%) had single-patch, 275(30.2%) had Warden’s procedure, 185(20.3%) had a double-patch and 159(17.5%) had use of autologous right atrial appendage for the anastomosis. The total follow-up was between 0.008-30 years. Sinus node dysfunction (SND) was the commonest complication occurring mostly in patients who had double-patch technique 16(8.6%) followed by 15(5.5%) patients with single-patch technique, 7(4.4%) patients in whom right atrial appendage was used and 5(1.8%) patients with Warden’s procedure. Venous obstruction occurred in 22(7.7%) patients with SP, 13(5.1%) patients with Warden’s Procedure and 5(2.7%) patients with double-patch. Conclusion: The two major complications, SND and venous obstruction, assumed a see-saw approach as surgical maneuvers avoiding venous obstruction encouraged SND and vice versa. However, adopting surgical options which avoided incision across the Cavoatrial junction attenuated all the complications.

KEYWORDS

Sinus Venosus-Atrial Septal Defect; Warden’s Procedure; Right Atrial Appendage; Single-Patch Technique; Double-Patch Technique

Share and Cite:

K. Okonta and M. Sanusi, "Superior Sinus Venosus Atrial Septal Defect: Overview of Surgical Options," Open Journal of Thoracic Surgery, Vol. 3 No. 4, 2013, pp. 114-122. doi: 10.4236/ojts.2013.34024.

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