Surgical repairs of anomalous pulmonary venous connection to superior vena cava and right atrial junction

: We recently encountered a case of total anomalous pulmonary venous connection (TAPVC, Darling Ib) and 3 cases of partial anomalous pulmonary venous connections (PAPVC) to the superior vena cava. We surgically treated these 4 cases by different procedures which were selected according to the morphological features of individual cases. In the case of TAPVC (Darling Ib), we created a right atrial wall flap, according to the method of Vargas, so that the blood from the abnormal pulmonary vein could pass the left atrium via the superior vena cava and atrial septal defect. In 3 cases of PAPVC, we modified some techniques of right atrial incision and closure by suturing. Through these surgical procedures, none of the 4 patients developed postoperative stenosis of the pulmonary venous pathway or arrhythmias. Various surgical procedures have been reported for the treatment of anomalous pulmonary venous connection, an anomaly involving direct connection of the pulmonary vein to the superior vena cava or to the right atrial junction of the superior vena cava. However, the incidence of postoperative stenosis or obstruction of the pulmonary venous pathway or postoperative sick sinus syndrome has been high with these procedures.