We describe a novel robotically assisted minimally invasive surgical technique for repair of partial anomalous pulmonary vein connection (PAPVC). Partial anomalous pulmonary vein connection is a rare congenital anomaly that consists in drainage of one or more pulmonary veins into the systemic venous system. Traditionally, large thoracotomy incision and sometimes establishment of cardiopulmonary bypass are needed to redirect the abnormal pulmonary vein to the left-sided reservoir. We describe a robotically assisted, minimally invasive, off-pump technique for the treatment of the left PAPVC in a 57-year-old patient with signs of progressive right ventricular dilatation. The Da Vinci robot was used for mediastinal dissection and isolation of the distal aspect of the left superior anomalous pulmonary vein from the brachiocephalic vein. Through a left minithoracotomy, under direct vision, the pulmonary vein was reanastomosed to the left atrial appendage, thus reconstituting a normal venous return pattern. The use of the da Vinci robot is a valid adjunct for correction of the left PAPVC. It helps mediastinal dissection and allows reconnection of the pulmonary vein to the left venous system via a small thoracotomic incision and without the use of cardiopulmonary bypass.
From the Heart and Vascular Institute of New York, Lenox Hill Hospital, Northwell Health System, New York, NY USA.
Accepted for publication August 7, 2016.
Disclosures: Chad A. Kliger, MD, is on the speaker's bureau for St. Jude Medical, Inc, St. Paul, MN USA, and Philips Healthcare, Amsterdam, The Netherlands. Luigi Pirelli, MD, Nirav C. Patel, MD, Marcella Bono, MS, Carlos E. Ruiz, MD, PhD, Vladimir Jelnin, MD, and Gregory P. Fontana, MD, declare no conflicts of interest.
Address correspondence and reprint requests to Luigi Pirelli, MD, 130 East 77th Street, 4th Floor, New York, NY 10075 USA. E-mail: firstname.lastname@example.org.