Modified cavoatrial anastomosis in Warden procedure.

The Warden procedure was introduced for surgical repair of partial anomalous pulmonary venous connection to the higher portion of the superior vena cava in an attempt to decrease the incidence of postoperative sinoatrial node dysfunction and pulmonary venous obstruction. However, postoperative cavoatrial channel stenosis and obstruction up to 20% and 10%, respectively, requiring catheter intervention has been reported. In this article, we describe a modified cavoatrial anastomotic technique to avoid postprocedural superior vena cava stenosis. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.