• Journal of Chest Surgery
• /
• v.25 no.10
• /
• pp.1146-1151
• /
• 1992

This report describes a month-old female infant with a rare supracardiac type of total anomalous pulmonary venous connection which have intrapulmonary drainage and small left atrium. The left pulmonary vein drained into right hilum via transverse common pulmonary vein, and then both pulmonary veins drained into superior vena cava via ascending connecting vein. This anomaly was sucessfully repaired by double patch technique.

• Proceedings of the KTCVS Conference
• /
• 1996.10a
• /
• pp.42-42
• /
• 1996

• Clinical and Experimental Pediatrics
• /
• v.52 no.2
• /
• pp.194-198
• /
• 2009

Purpose : Active perioperative intervention and improvement on surgical technique has decreased the mortality rate of total anomalous pulmonary venous connection (TAPVC); however, when complicated with pulmonary venous obstruction, operative mortality is still high. The purpose of this study was to investigate the clinical course of TAPVC. Methods : Twenty-seven patients who were diagnosed with TAPVC (without other complex heart anomalies) by echocardiogram at Kyungpook National University Hospital from January 1994 to February 2008 were included. Results : Mean age at diagnosis was $28.1{\pm}33.4$ days (1-126 days). Sites of drainage were supracardiac type (15), cardiac (6), infracardiac (5), and mixed (1). Seven patients had pulmonary venous obstruction: 5 with supracardiac type, 1 with cardiac, and 1 with infracardiac. Intraoperative trans-esophageal echocardiograms were performed in 14 patients (58.3%). The operative mortality was 16.7% (4 of 24) and overall hospital mortality (including deaths without operation) was 22.2% (6 of 27). There were 5 postoperative pulmonary venous obstructions. The sites of obstruction were anastomotic in 3 of 5 (60%) patients, and ostial pulmonary vein in the other 2 (40%) patients. Three patients who presented with anastomotic pulmonary venous obstruction underwent reoperation, but all the patients were found to have pulmonary venous anastomotic obstruction. The other 2 patients with ostial pulmonary vein obstruction who had no significant symptoms were diagnosed by routine echocardiographic examination during follow-up. Conclusion : In TAPVC patients, early diagnosis and aggressive surgical management will improve prognosis, and we must pay attention to early and late pulmonary vein restenosis through intraoperative trans-esophageal echocardiogram and peri- and post-operative echocardiographic follow-up examinations.

• Journal of Chest Surgery
• /
• v.40 no.8
• /
• pp.569-573
• /
• 2007

A 3 month old female baby, who had been diagnosed with right atrial isomerism associated with total anomalous pulmonary venous return (TAPVR), a functional single ventricle and major aortopulmonary collateral arteries (MAPCA), underwent left MAPCA unifocalization and left Blalock-Taussig shunt (3.5 mm) at 3 months of age. The post-operative course was complicated by pulmonary venous congestion, and the drainage site of the TAPVR was found to be stenotic on echocardiography. We performed sutureless repair of the TAPVR along with unifocalization of the right MAPCA. She was put on an extracorporeal membrane oxygenator for 8 days after the 2nd operation, and she was able to come off the oxygenator with the placement of a central shunt (3 mm). She developed tracheal stenosis, which was presumably due to longstanding endotracheal intubation, and she then underwent tracheostomy. She was discharged to home on day 104 after the 1st operation, and she has been followed up for 2 months in a good clinical condition.

• Journal of Chest Surgery
• /
• v.23 no.5
• /
• pp.944-952
• /
• 1990

In 1989, We experienced 2 cases of T.A.P.V.D. corrected successfully under cardiopulmonary bypass. The first case was 27 years old male with mild dyspnea on exertion and easy fatigability. All clinical symptoms, physical examinations, laboratory findings, echocardiogram, cardiac catheterization and angiogram revealed supracardiac type T.A.P.V.D. drained through left innominate vein. Operation was done by manner of modified Schumacker procedure. The other case was 6 years old male with cardiac type drained to right atrium through coronary sinus. Two patients were well in postoperative 15 and 8 months.

• Journal of Chest Surgery
• /
• v.28 no.12
• /
• pp.1174-1177
• /
• 1995

We experienced one case of TAPVC patient who was 39 years old man with mild dyspnea on exertion and easy fatigability. He was the oldest patient among TAPVC which was reported in Korea. Preoperative echocardiogram, cardiac catheterization and angiogram revealed supracardiac type TAPVC drained through left innominate vein. An anastomosis between common pulmonary venous trunk and left atrium, pericardial patch closure of ASD and ligation of left vertical vein were performed with extracorporeal circulation. The postoperative course was uneventful and discharged with excellent general condition and has been well during 8 months follow-up.

• Journal of Chest Surgery
• /
• v.25 no.12
• /
• pp.1465-1470
• /
• 1992

We experienced one case of total anomalous pulmonary venous connection to coronary sinus with secondum type ASD. The case was 21 years old woman with mild dyspnea on exertion and ill looking appearance. The disease was confirmed by 2D echocardiogram and cardiac catheterization. Under the conventional cardiopulmonary bypass, we repaired the anomaly by use of Dacron patch. The postoperative course was uneventful and discharged with excellent general condition and has been good during follow-up.

• Journal of Chest Surgery
• /
• v.29 no.3
• /
• pp.292-296
• /
• 1996

Total anomalous pulmonary venous return is a rare but serious cardiac malformation, accounting for only about 1.5~3% of congenital heart disease. Surgical results have been dramatically improved in the last two decades, largely owing to improved techniques of cardiopulmonary bypass and perloperative management. Seven patients ranging in age from 15 days to 11 years with total anomalous pulmonary venous return underwent repair between 1984 and 1995. The types of anomalous return were supracardiac in 5, and cardiac in 2. There were 5 boys and 2 girls. There were two hospital death, occurred in 15-day-old, and 40-day-old infants with supracardiac type. Follow-up periods have ranged from 3 months to 11 years, and all survivors have remained asymptomatic with normal growth and development.

• Journal of Chest Surgery
• /
• v.24 no.9
• /
• pp.930-944
• /
• 1991

Infants born with TAPVR have a generally unfavorable prognosis, only a bout 20% surviving first year of life. In fact only about 50% survive beyond the age of 3 months, death occurring in the first few weeks or months of life. In 1991, we experienced 1 case of TAPVR of cardiac type in infant[2 months old age, W; 3.4kg] Repair was performed under the deep hypothermia with CPB, and continuous low-perfusion technique. The septum between enlarged coronary sinus opening and left atrium was carefully excised. A patch of pericardium was then sutured around the coronary sinus and ASD, so that the blood from the pulmonary veins and the coronary sinus was diverted in the left atrium. The postoperative course was uneventful except pneumothorax. The patient has been doing well on 6 months follow-up.

• Journal of Chest Surgery
• /
• v.26 no.4
• /
• pp.260-265
• /
• 1993

Twelve patients underwent surgical correction of total anomalous pulmonary venous connection[TAPVC] between Sep. 1989 and May 1993. There were 9 boys and 3 girls whose ages ranged from 10 days to 17 month [median 1.2 month]. Six patients were less than 1 month of age at operation. The anomalous drainage was supracardiac in 6, cardiac in 2, infracardiac in 2, and mixed in 2. There were 3 early death, and its mortality rate was 25%. There were no operative mortality after Sep. 1991. Age at operation, presence of preoperative pulmonary venous obstruction, preoperative assisted ventilation and type of anomaly did not affect early mortality. Late pulmonary venous obstruction was developed in 4 patients between 1 month to 4 month after operation. Among these patients, 2 were died and one was reoperated and well, and the other one was not operated because of patient`s refusal. We conclude that late pulmonary venous obstruction is fatal and its early detection and correction is important for improving late survival.