Repair of Superior Sinus Venosus Atrial Septal Defect Using a Modified Two-patch Technique

ABSTRACT Background Surgical repair of superior sinus venosus atrial septal defect (SVASD) associated with partial anomalous pulmonary venous connection (PAPVC) is usually performed with either a two-patch technique or the Warden procedure. However both techniques can lead to superior vena cava and/or pulmonary vein stenosis, as well as sinus node dysfunction. To prevent these complications, we have utilized a modified two-patch technique. Methods between 1/2000 and 12/2015, 44 patients underwent modified two-patch repair of superior SVASD associated with PAPVC at our institution. The technique utilizes the right atrial appendage to patch the superior vena cava (SVC) and avoid SVC obstruction. Patients' data were collected from reviewing hospital charts and clinic records. Results Mean age was 10.3 years (range 0.68 - 61 years). There was no hospital mortality. Six patients (13.6%) developed sinus node dysfunction after surgery. All of them recovered their normal sinus node function on a mean follow-up period of 45.7 months. No superior vena cava or pulmonary vein stenosis was observed at long-term follow-up. Conclusions A modified two-patch technique is a valid alternative to other methods of superior SVASD and PAPVC repair, and prevents late systemic/pulmonary venous pathway obstruction while maintaining sinus rhythm.