Abstract
Objective. To evaluate the results of SVC reconstruction using the right atrial appendage for correction of PAPVC into the SVC in pediatric patients.
Material and methods. From 2012 to 2025, 100 patients aged 0.6 to 17.9 years with a diagnosis of PAPVC in the SVC were operated on. Correction of the defect was performed using right atrial appendage to expand the SVC. In the postoperative periods, the patients were assessed for the presence of a critical pressure gradient in the SVC and pulmonary venous collector and cardiac arrhythmia.
Results. There was no in-hospital mortality. In the first days after surgery, sinus rhythm was observed in 40 patients (40%), and cardiac arrhythmias in 60 (60%). At discharge, sinus rhythm was detected in 58 patients (58%). Sinus node dysfunction (SND) was diagnosed in 41 patients (41%), one of whom required implantation of a single-chamber pacemaker. Frequent supraventricular extrasystoles (SVEs) were detected in one patient. In the long-term period, 61 patients (61%) were examined. The average follow-up period was 3.1 years (σ – 1.1; 5.1). Sinus rhythm was maintained in 34 patients (55.7%), SND in 26 (42.6%), and SVEs in one (1.6%). No cases of SVC or pulmonary venous collector obstruction were registered during the entire follow-up period.
Conclusion. Expansion of the SVC with the RA appendage during correction of the PAPVC in the SVC is an effective method that allows avoiding the development of obstruction of the SVC and pulmonary veins, however, the risk of developing SND remains relatively high.
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About the authors
- Konstantin V. Shatalov, Dr. Med. Sci., Professor, Head of Department; ORCID
- Sergey V. Patsera, Resident Physician; ORCID
- Konstantine M. Dzhidzhikhiya, Dr. Med. Sci., Chief of Department, Cardiovascular Surgeon; ORCID
- Rustam R. Akhtiamov, Cardiovascular Surgeon; ORCID
