Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Outcomes of Surgery for Total Anomalous Pulmonary Venous Return without Total Circulatory Arrest

  • Lee, Youngok (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine) ;
  • Cho, Joon Yong (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine) ;
  • Kwon, O Young (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine) ;
  • Jang, Woo Sung (Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine)
  • Received : 2015.09.01
  • Accepted : 2015.10.22
  • Published : 2016.10.05
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Abstract

Background: Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair. However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation. We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes. Methods: We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015. All patients were newborns or infants who underwent in situ TAPVR repair without TCA. Results: Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%). The median follow-up period for all patients was 42.9 months. Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO). Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality. Conclusion: In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes. Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair.

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References

  1. Karamlou T, Gurofsky R, Al Sukhni E, et al. Factors associated with mortality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation 2007;115:1591-8. https://doi.org/10.1161/CIRCULATIONAHA.106.635441
  2. Caldarone CA, Najm HK, Kadletz M, et al. Surgical management of total anomalous pulmonary venous drainage: impact of coexisting cardiac anomalies. Ann Thorac Surg 1998;66:1521-6. https://doi.org/10.1016/S0003-4975(98)00951-5
  3. Whight CM, Barratt-Boyes BG, Calder AL, Neutze JM, Brandt PW. Total anomalous pulmonary venous connection: longterm results following repair in infancy. J Thorac Cardiovasc Surg 1978;75:52-63.
  4. Stark J. Anomalies of pulmonary venous return. World J Surg 1985;9:532-42. https://doi.org/10.1007/BF01656055
  5. Bando K, Turrentine MW, Ensing GJ, et al. Surgical management of total anomalous pulmonary venous connection: thirty-year trends. Circulation 1996;94(9 Suppl):II12-6.
  6. Caldarone CA, Najm HK, Kadletz M, et al. Relentless pulmonary vein stenosis after repair of total anomalous pulmonary venous drainage. Ann Thorac Surg 1998;66:1514-20. https://doi.org/10.1016/S0003-4975(98)00952-7
  7. Sano S, Brawn WJ, Mee RB. Total anomalous pulmonary venous drainage. J Thorac Cardiovasc Surg 1989;97:886-92.
  8. Wilson WR Jr, Ilbawi MN, DeLeon SY, et al. Technical modifications for improved results in total anomalous pulmonary venous drainage. J Thorac Cardiovasc Surg 1992;103: 861-70.
  9. Kanter KR. Surgical repair of total anomalous pulmonary venous connection. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2006;9:40-4. https://doi.org/10.1053/j.pcsu.2006.02.015
  10. Hancock Friesen CL, Zurakowski D, Thiagarajan RR, et al. Total anomalous pulmonary venous connection: an analysis of current management strategies in a single institution. Ann Thorac Surg 2005;79:596-606. https://doi.org/10.1016/j.athoracsur.2004.07.005
  11. Jonas RA. Total anomalous pulmonary venous connection. Oper Tech Thorac Cardiovasc Surg 2007;11:286-94.
  12. Greeley WJ, Ungerleider RM, Smith LR, Reves JG. The effects of deep hypothermic cardiopulmonary bypass and total circulatory arrest on cerebral blood flow in infants and children. J Thorac Cardiovasc Surg 1989;97:737-45.
  13. Husain SA, Maldonado E, Rasch D, et al. Total anomalous pulmonary venous connection: factors associated with mortality and recurrent pulmonary venous obstruction. Ann Thorac Surg 2012;94:825-31. https://doi.org/10.1016/j.athoracsur.2012.04.026

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