Sutureless technique use in the surgery for total anomalous pulmonary venous connection in neonates
10.7507/1007-4848.201612049
- VernacularTitle:Sutureless 技术在新生儿完全性肺静脉异位引流中的应用
- Author:
LI Xiaohua
1
;
CHEN Jimei
1
;
ZHUANG Jian
1
;
NIE Zhiqiang
1
;
CEN Jianzheng
1
;
WEN Shusheng
1
;
XU Gang
1
;
GAO Qiang
1
;
ZHAO Junfei
1
Author Information
1. Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510100, P.R.China
- Publication Type:Journal Article
- Keywords:
Sutureless technique;
neonates;
total anomalous pulmonary venous connection;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2017;24(9):661-666
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the sutureless technique use in the surgical repair for total anomalous pulmonary venous connection in neonates. Methods Between September 2002 and December 2015, 71 consecutive neonates with supracardiac or infracardiac type total anomalous pulmonary venous connection who underwent surgical repair in our institute were included in this study. There were 57 males and 14 females at median age of 8 (1, 29) d. And the median body weight was 3.3 (2.1, 4.7) kg. There were 45 patients (63.4%) with supracardiac, 26 patients (36.6%) with infracardiac. Patients were divided into two groups: a conventional technique group (29 patients) and a sutureless technique group (42 patients). To control for potential differences in the characteristics of patients between the sutureless technique group and the conventional technique group, the method of propensity-score matching was used. Results Basic characteristics of patients after propensity-score were not different.There were 11 operative deaths (15.5%), 7 late deaths (96.%), total 18 deaths (25.4%). The mortality was 58.6% (17/29) in the conventional technique group, 2.4% (1/42) in the sutureless technique group (P=0.000). Kaplan-Meier survival curve showed a difference in mortality between the two groups (P=0.005). The patients were followed up for 25.5 (1.0-13.0) months.Postoperative anastomotic or pulmonary vein stenosis occurred in 12 patients, 8 of them died at a higher mortality than that of the patients with smooth anastomosis [66.7% (8/12) vs. 16.9% (10/59), P=0.001]. Conclusion The patients who have postoperative anastomotic or pulmonary vein stenosis have higher mortality. Compared with conventional technique, sutureless technique can dramatically decrease the incidence of postoperative anastomotic or pulmonary vein stenosis and the mortality of surgical repair for total anomalous pulmonary venous connection in neonates.
