Nigerian Journal of Cardiology

ORIGINAL ARTICLE
Year
: 2013  |  Volume : 10  |  Issue : 2  |  Page : 68--71

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

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.


How to cite this article:
Okonta KE, Agarwal V. Caval division technique and venous drainage after surgery for sinus venosus atrial septal defect.Nig J Cardiol 2013;10:68-71


How to cite this URL:
Okonta KE, Agarwal V. Caval division technique and venous drainage after surgery for sinus venosus atrial septal defect. Nig J Cardiol [serial online] 2013 [cited 2022 Aug 15 ];10:68-71
Available from: https://www.nigjcardiol.org/article.asp?issn=0189-7969;year=2013;volume=10;issue=2;spage=68;epage=71;aulast=Okonta;type=0