Surgical correction of PAPVC varies according to the type of underlying anomaly, however the basic principle remains the segregtion of systemic and pulmonary circulation either by communicating the anomalous pulmonary vein to the left atrium directly or indirectly rerouting through baffle into left atrium.
For right-sided PAPVC to SVC, intra cardiac baffle with double patch technique was done in 39 patients in whom right superior pulmonary vein was draining into superior vena cava.
For right sided PAPVC to right atrium, intra atrial septum was excised to create atrial septal defect and pulmonary veins were rerouted into left atrium in two patients while in one patient there was secundum ASD already so pulmonary vein was rerouted by autologous pericardial patch after enlarging atrial septal defect.
For bilateral PAPVC, in one patient atrial septal defect was enlarged and coronary sinus was unroofed and single autologous patch was used to reroute the pulmonary veins and coronary sinus into left atrium.
Table-I: Preoperative baseline characteristic and types of PAPVC.
Various techniques have been described for correction of PAPVC and these repair techniques have evolved over years.
We used predominantly, intracardiac baffle with double patch technique in right-sided PAPVC to SVC with very low incidence of surgical morbidity.