Warden procedure is a popular technique for repairing partial anomalous pulmonary venous connection. We describe a modification of this technique for surgical repair of this condition by raising both a superior vena cava (SVC) flap and right atrial appendage flap to create a tension-free SVC-RA continuity (neo-SVC). The anomalous pulmonary veins are routed via the remanent of proximal SVC and baffled to the left atrium across a surgically created or enlarged atrial septal defect using autologous pericardium.
AlpertJSDexterLViewegWVHaynesFWDalenJE. Anomalous pulmonary venous return with intact atrial septum: diagnosis and pathophysiology. Circulation. 1977;56(5):870‐875.
2.
BroyCBennettS. Partial anomalous pulmonary venous return. Mil Med. 2008;173(6):523-524.
3.
WardenHEGustafsonRATarnayTJNealWA. An alternative method for repair of partial anomalous pulmonary venous connection to the superior vena cava. Ann Thorac Surg. 1984;38(6):601-605.
4.
StewartRDBailliardFKelleAMBackerCLYoungLMavroudisC. Evolving surgical strategy for sinus venosus atrial septal defect: effect on sinus node function and late venous obstruction. Ann Thorac Surg. 2007;84(5):1651-1655.
5.
SaidSMBurkhartHMDearaniJA, et al.Outcome of caval division techniques for partial anomalous pulmonary venous connections to the superior vena cava. Ann Thorac Surg. 2011;92(3):980-984.
6.
KumarTKSChenDHalpernD, et al.Modified Warden operation using aortic homograft. J Thorac Cardiovasc Surg Tech. 2020;4:271-273.
7.
TaoKPanWLinK, et al.Modified cavoatrial anastomosis in Warden procedure. Ann Thorac Surg. 2010;89(6):2047-2048.
8.
KimCChoYHLeeM, et al.Surgery for partial anomalous pulmonary venous connections: Modification of the warden procedure with a right atrial appendage flap. Korean J Thorac Cardiovasc Surg. 2014;47(2):94-99.
