Page 88 - BH-2-2

Brain & Heart

CASE REPORT
Surgical anastomosis of vertical vein to left atrial

appendage: A case report of technical aspects

Gananjay G. Salve* , Danish A. K. Memon, Veeresh Manvi, Parishwanath B. Patil,
Nidhi G. Manvi, Mohan D. Gan , and Richard Saldanha
Department of Cardiovascular and Thoracic Surgery, KLE’s Dr. Prabhakar Kore Hospital and Medical
Research Centre, Belgaum, Karnataka, India

Abstract

Management of partial anomalous pulmonary venous connection (PAPVC) differs
significantly between the defect on the left side, which is adjacent to left atrial appendage,
and that on the right one adjacent to the interatrial septum. Here, we report two patients
operated at our center. The first case is an adult diagnosed with the left-sided PAPVC
draining to an innominate vein through a left-sided vertical vein, and with a large
ostium secundum atrial septal defect. The second case is a neonate with mixed-type
total anomalous pulmonary venous connection with all right pulmonary veins opening
into the coronary sinus, and all the left pulmonary veins connecting to the innominate
vein through a left-sided vertical vein. Both patients experienced severe pulmonary
arterial hypertension, necessitating surgical treatment involving disconnection of the
vertical vein from its junction, or, ligation of the vertical vein-innominate vein junction,
coupled with its redirection to the left atrial appendage. We employed different surgical
procedures on these patients, given the distinct age difference, intending to anastomose
*Corresponding author: their respective vertical veins to the adjacent left atrial appendage. In this report,
Gananjay G. Salve the technical aspects of anastomosing vertical vein to left atrial appendage, to avoid
(gananjay.salve@gmail.com) pulmonary venous obstruction in these two patients, are discussed.
Citation: Salve GG, Memon DAK,
Manvi V, et al. Surgical anastomosis
of vertical vein to left atrial Keywords: Anomalous pulmonary venous connection; Vertical vein; Left atrial
appendage: A case report of appendage; Secundum atrial septal defect; Technical aspects
technical aspects. Brain & Heart.
2024;2(2):2376.
doi: 10.36922/bh.2376
Received: December 5, 2023 1. Background
Accepted: February 27, 2024
Partial anomalous pulmonary venous connection (PAPVC) reportedly occurs at a rate
Published Online: May 2, 2024 of 0.4 – 0.7% on autopsy examination, with only 10% of the cases affecting left-sided
1
2
Copyright: © 2024 Author(s). pulmonary veins. The incidence of total anomalous pulmonary venous connection
This is an Open-Access article (TAPVC) accounts for approximately 2% of all congenital heart defects. Constituting
3
distributed under the terms of the
Creative Commons Attribution only 5% of all the TAPVC cases, its mixed-type form has the least incidence rate. 4
License, permitting distribution,
and reproduction in any medium, In this report, we describe two patients, the first patient is an adult diagnosed with
provided the original work is the left-sided PAPVC draining to the innominate vein through a vertical vein, coupled
properly cited. with a large ostium secundum atrial septal defect (ASD). The second patient is a neonate
Publisher’s Note: AccScience diagnosed with mixed-type TAPVC, characterized by the right-sided pulmonary veins
Publishing remains neutral with opening into the coronary sinus directly, and the left-sided ones forming a vertical vein
regard to jurisdictional claims in
published maps and institutional and draining into the innominate vein. Drawing on the treatment experiences for these
affiliations. patients, we compile the key technical aspects of administering the surgical treatment,

Volume 2 Issue 2 (2024) 1 doi: 10.36922/bh.2376