Case presentation:
A 2-year-old girl was presented to our hospital when her parents noticed
that she had suffered from moderate tachypnea recently. Physical
examination revealed a 3/6 systolic murmur on the left sternal border
and there was not any cyanosis. TTE showed an ASD of coronary sinus type
of about 1.5 cm with dilated right heart cavities. The patient was
scheduled for surgical closure of the ASD. Upon anaesthesia, oxygen
saturation (SaO2) was 100%, and the operation was performed through
median sternotomy. The pericardium was opened, and PLSVC was noticed.
Complete cardiopulmonary bypass (CPB) was prepared without cannulating
the PLSVC. The heart was arrested by antegrade cold blood cardioplegic
solution. The right atrium (RA) was opened with an incision parallel to
the right atrioventricular groove as usual. On inspection, we found that
the PLSVC was draining into the roof of the LA, and a venous cannula was
directed through the ASD towards its orifice to drain it (Figure 1). The
pulmonary veins drainage and the mitral valve were inspected. A fresh
autologous pericardial patch was used to construct a tunnel that drains
the PLSVC into RA (Figure 2). The ASD was closed by another fresh
autologous pericardial patch and thus the PLSVC will drain into RA
(Figure 3). The remainder of the operation was completed uneventfully.