Correction of partial anomalous right upper pulmonary veins connection to the superior vena cava: comparative analysis of long-term results

The aim of the study was to evaluate the frequency of cardiac arrhythmias and superior vena cava (SVC) stenosis in early and late period after surgical correction of partial anomalous right pulmonary venous connection (PARPVC) to the SVC. Materials and Methods. Analysis was performed in 48 patients with PARPVC to SVC and atrial septal defect (ASD) at age ranging from 1 month to 58 years (6.30±11.23 years; Ме=3.00 years); 26 patients were male (54%). Three types of operations were performed: intraatrial SVC plasty (group 1, n=18), Warden procedure (group 2, n=22), and modified Warden procedure (group 3, n=8). Clinical assessment, electrocardiogram (ECG), Holter monitoring, echocardiography (Echo) with the evaluation of the flow velocity and the peak pressure gradient in SVC were provided before, 10 days and 1 year after surgical correction. Results. The patients of three groups did not differ in baseline clinical and echocardiographic parameters. During the first 10 days after surgery, significant reduction in the size of the right chambers of the heart was found in all groups; in the late period, the right atrium (RA) volume and the size of the right ventricle (RV) remained normal in all three groups. In group 2, peak and mean gradients in the SVC were increased, which did not change in the long term. The incidence rates of cardiac arrhythmias after surgery were 55.6% in group 1 and 18.1% in group 2. In group 3, cardiac arrhythmias were absent in the early and late postoperative period. Conclusions: current methods of PARPVC correction are effective; the lowest frequency of cardiac arrhythmias in the early and late period was observed when PARPVC was corrected using a modified Warden procedure; PARPVC correction by Warden procedure was associated with an increase in peak and average gradients of SVC in the early postoperative period, which did not change in the long term.