Modified “Sutureless” Anastomosis for Primary Repair of Supracardiac Total Anomalous Pulmonary Venous Connection

  Repair of total anomalous pulmonary venous connection (TAPVC) is associated with a risk of recurrent pulmonary venous obstruction. In this article we describe a technique of primary repair using a posterior approach in which a modified sutureless anastomosis is constructed by suturing the left atrium to the posterior pericardium that surrounds the pulmonary venous confluence. This technique avoids trauma to the pulmonary venous wall and minimizes the risk of distortion of the anastomosis, factors that have been implicated in the occurrence of subsequent pulmonary venous obstruction .