Surgical prognosis for infracardiac total anomalous pulmonary venous connection: experience in a single institution
10.3760/cma.j.cn112434-20230526-00113
- VernacularTitle:心下型完全性肺静脉异位引流术后预后分析：单中心经验
- Author:
Miaoyun CHEN
1
;
Furong LIU
;
Xiaobing LIU
;
Jimei CHEN
;
Shusheng WEN
;
Haiyun YUAN
;
Jianzheng CEN
;
Jian ZHUANG
Author Information
1. 南方医科大学附属广东省人民医院 广东省医学科学院 广东省心血管病研究所 心外重症监护室，广州 510800
- Keywords:
Infracardiac;
Total anomalous pulmonary venous connection;
Sutureless;
Prognosis
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(1):28-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed at reviewing surgical experiences and exploring risk factors for mortality and postoperative complications in patients with infracardiac total anomalous pulmonary venous connection (TAPVC).Methods:This retrospective study included 74 infants who underwent conventional repair (28 cases) and sutureless repair (46 cases) in one hospital from February 2009 to December 2022. Clinical data were reviewed to assess risk factors for mortality and postoperative pulmonary venous obstruction (PVO). Kaplan- Meier curves and cox regressions were applied to analyze the overall survival. Cumulative incidence curve and sub-distribution hazard models were used to evaluate postoperative PVO. Results:There were 4 early deaths and 3 late deaths, and the overall survival rate was 90.5%. A total of 12 patients complicated postoperative PVO. The median follow-up was 39.4 months ( IQR: 13.3 to 73.7 months). The overall survival rate was higher in the sutureless group than the conventional group ( P=0.003). The incidence rate of postoperative PVO in the conventional group was higher than that in the sutureless group ( P= 0.008). Risk factors for recurrent PVO included longer cardiopulmonary bypass time, the increase of direct bilirubin level and international normalized ratio level before surgical repair. Conclusion:Both sutureless and conventional repairs for patients with infracardiac TAPVC can achieve acceptable postoperative outcomes. Sutureless repair has a higher survival rate and a lower incidence of re-stenosis in pulmonary veins and anastomosis.
