| ORIGINAL ARTICLE |
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| Year : 2013 | Volume
: 10
| Issue : 2 | Page : 68-71 |
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Caval division technique and venous drainage after surgery for sinus venosus atrial septal defect
Kelechi E Okonta1, Vijay Agarwal2
1 Department of Surgery, Division of Cardiothoracic Surgery, University of Port-Harcourt, PMB 5323, Port-Harcourt, Nigeria
2 Department of Cardiac Surgery, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu, India
Correspondence Address:
Kelechi E Okonta
Department of Surgery, Division of Cardiothoracic Surgery, University of Port-Harcourt, PMB 5323, Port-Harcourt
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0189-7969.127003
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Bacgrounnd: The main reason for the adoption of the caval division technique is primarily to avoid sinus node dysfunction post-operatively. Equally, this technique also has the advantage of reduced complication of venous obstruction either across the superior vena cava right atrial (SVC-RA) appendage junction and/or pulmonary veins area.
Objectives: To assess the impact of Caval Division Technique on venous drainage after surgery.
Methods: The medical records for 38 consecutive patients who had a sinus venous atrial septal defect repair using the caval division technique from September 2009 to October 2011 were retrospectively reviewed and grouped into two: A total of 33 patients with normal intraoperative pressure across the anastomotic and venous areas (Group 1) and 5 patients with increased intraoperative venous pressure gradient across these areas (Group 2) with 1 patient in Group 2 having immediate surgical intervention.
Results: The pressure across the cavoatrial anastomotic sites in 2 patients was 8 mmHg, in 2 patients was 6 mmHg and in 1 patient was 11 mmHg as indicated by the intraoperative pressure monitoring line and/or transesophageal echocardiograpy. However, the echocardiography performed at follow up showed no gradient across the SVC-RA appendage anastomotic site and there was no mortality recorded.
Conclusion: In conclusion, the early operative impact of the caval division technique on venous drainage is of a good outcome and even when detected by intraoperative pressure line monitoring or transesophageal echocardiography, it can resolved spontaneous or attended to by additional band resections, especially in young children. |
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