The Technique of Surgical Correction of Anomalies of the Pulmonary Veins in a Series of 25 Cases

Abstract

In this paper we intend to confine ourselves to the strictly surgical aspects of anomalies of the pulmonary veins in a series of 25 patients who were operated on in this clinic.Anomalies of the pulmonary veins are very often associated with communications between the systemic and the pulmonary circulation, such as atrial septal defect, patent ductus arteriosus, or ventricular septal defect.An atrial septal defect existed in 23 of these 25 cases, and a ventricular septal defect in one; only one patient showed an intact atrial septum (partial anomaly of the pulmonary veins).In none of these cases was a patent ductus arteriosus found.In two, the anomaly of the pulmonary veins was associated with coarctation of the aorta.The various lesions are classified in Table I.TABLE I CLASSIFICATION OF 25 CASES OF ANOMALIES OF PULMONARY VEINS TREATED SURGICALLY Complete transposition of pulmonary veins 2 cases Partial transposition of pulmonary veins ..23 cases 22 right-sided cases (all pulmonary veins in 7, part ofthe veins in 15) One left-sided case COMPLETE TRANSPOSITION OF PULMONARY VEINS This is a rare anomaly.Guntheroth, Nadas, and Gross recently reported that only 159 cases have been described in the literature, usually as necropsy findings.Two cases were submitted to operation in this clinic.(Observations on all types of complete transposition of the pulmonary veins are presented in a paper by A. Dekker, of the Anatomical Institute, Leyden.)FIG.1.-A drawing to show the large common trunk collecting the four pulmonary veins.Notethe narrow anastomosis that in this case connects it with the coronary sinus.