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
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.
Kelechi E Okonta
Department of Surgery, Division of Cardiothoracic Surgery, University of Port-Harcourt, PMB 5323, Port-Harcourt
|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