A collection of congenital cardiac defects known as TAPVC are those in which the pulmonary veins empty into the right atrium or any of its branches. Based on the level of the anomalous connecting vein’s connection, TAPVCs are divided into four categories: supracardiac, cardiac, infracardiac, and mixed. By determining whether restricted pulmonary venous drainage is present or not, TAPVs can be further divided into obstructive and nonobstructive varieties. A variety of surgical corrective techniques are required in this case.
This video summarizes each step of the lateral approach surgical repair of a supracardiac TAPVC. The lateral approach yields a good long-term result and is simpler, more reproducible, and less time consuming than other surgical techniques.
References
- Shi G, Zhu Z, Chen J, Ou Y, et al. Total Anomalous Pulmonary Venous Connection. Circulation. 2017;135(1):48–58.
- Fraser C. “Lateral” Approach to Surgical Repair of Total Anomalous Pulmonary Venous Return. Operative Techniques in Thoracic and Cardiovascular Surgery. 2006;11(4):275–285.
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2 Comments
Thank you for sharing your video, I have almost the same case. I will operate on it in 2 weeks. How much do you cool down? Do you perform the sutureless repair or endocardium to endocardium? Do you consider using a rubber band at the moment to ligate the vertical vein? In theory, can be a choice in case of any pulmonary vein obstruction?
Thank you for your comments.
If it is a baby with severe PAH, we may cool to 28-30 degrees, otherwise 30-32.
We reserve sutureless for redos and difficult anatomy in newborns , we prefer and perform endocardium to endothelium regularly.
We loop the vertical vein and snug and check hemodynamics after coming off, if stable , we ligate it off, if there is any problem , we either band it or leave it open. We use umbilical cotton tape for banding.
We ligate and divide VV in infracardiac variety to release tension and give more tissue to CC.
Regards.
Dr Anish Gupta