Comparative analysis of complications after surgical correction of partial anomalous right pulmonary venous connection in the superior vena cava

The aim of the study was to evaluate the frequency of cardiac arrhythmias and the peak pressure gradient in the superior vena cava in patients after surgical correction of partial anomalous right pulmonary venous connection (PARPVC) in the superior vena cava (SVC). Analysis was performed in 49 patients with PARPVC in SVC. Patients were divided into 3 groups: (1) patients after intraatrial SVC plasty (n=18); (2) patients after Warden procedure (n=22), and (3) patients after modified Warden procedure (n=8). The flow velocity and the peak pressure gradient in SVC were measured before and after surgical correction. The frequency of heart arrhythmias was evaluated by electrocardiogram and Holter monitoring before and after the operation. Significant dynamics in the average heart rates was found in the group of patients who underwent intraatrial SVC plasty. The frequency of cardiac arrhythmias after surgery was 55.6%. The most common complication was sick sinus syndrome. Peak pressure gradient in SVC was 5.94±2.36 mm Hg (Me=6.00) before operation and 7.22±3.07 mm Hg (Me=7.00) after the surgery. There was no significant dynamics of heart rate after surgery in Warden procedure group. Cardiac arrhythmias were detected in 18.1% of patients in this group in early postoperative period. Sick sinus syndrome and pacemaker migration were detected more frequently after Warden procedure as well as in the first group of patients. Peak pressure gradients were 5.13±1.7 mm Hg (Me=5.00) before Warden procedure and 9.76±6.69 mm Hg after surgery (Me=9.00). Cardiac arrhythmias were not detected in patients who underwent the modified Warden correction. Peak pressure gradients were 6.00±1.19 mm Hg (Me=6.50) before the operation and 3.50±1.37 mm Hg (Me=3.00) after the correction in this group of patients. The lowest frequency of cardiac arrhythmias and increase in SVC pressure gradient were observed after surgical correction of PARPVC in SVC by the modified Warden procedure.