Surgical treatment of total anomalous pulmonary venous connection Darling type Ib using pedicled right atrial flap
Nemoto, S.; Imai, Y.; Hoshino, S.; Ishihara, K.; Sawatari, K.; Misumi, H.; Terada, M.; Hiramatsu, T.; Hikawa, H.
Kyobu Geka. Japanese Journal of Thoracic Surgery 45(10): 878-882
1992
ISSN/ISBN: 0021-5252 PMID: 1518200 Document Number: 390675
A one-month-old baby with total anomalous pulmonary venous connection (TAPVC) type Ib underwent a total correction with a pedicled right atrial (RA) flap, which was made by incising the RA wall in a quadrangular configuration. The common pulmonary vein (PV) was cut back into the left atrium (LA). Then the RA flap was sutured along the limbus of PV recess and atrial septal defect (ASD) to create a new pulmonary venous channel. The defect in the RA wall was directly closed without any prosthetic patch. Absorbable sutures (# 6-0 PDS) were used throughout. Postoperative course was uneventful and echocardiogram showed widely opened PV channel draining into the LA. We think that this procedure could be applied in various types of total and partial anomalous pulmonary venous connection, avoiding pulmonary venous obstruction on the assumption that the RA flap should grow.