Diagnosis and surgical treatment of partial anomalous pulmonary venous connection

Objectives: Describe the current management of partial anomalous pulmonary veins. Background: Partial anomalous pulmonary venous connection (PAPVC) is a rare entity, with highly variable connections. Management requires an individualized approach to identification and surgical repair. Methods: Retrospective chart review of patients who underwent surgical repair of PAPVC between 2002 and 2012 at this institution. A variety of modalities were utilized to diagnose each patient, with ultimate confirmation of diagnosis at surgical intervention. Early and long term surgical outcomes were assessed. Results: 31 consecutive patients were identified who had operative intervention for PAPVC. The diagnosis was made by a variety of modalities including echocardiogram, cardiac catheterization, CT/CTA, and MRI/MRA. The repair strategy over this period of time included single or double patch repair, Warden procedure, or direct reanastomosis. There was no mortality and no patients required pacemaker implantation. Freedom from further cardiac intervention was 93%. There were 3 (11%) patients who developed superior vena cava obstruction and 2 (7%) required intervention. Conclusion: PAPVC is a rare entity requiring a personalized approach to diagnosis and repair. Contemporary surgical treatment of PAPVC is associated with good outcomes and low morbidity.