Surgical treatment of infracardiac total anomalous pulmonary venous connection: A retrospective cohort study
- VernacularTitle:心下型完全性肺静脉异位引流外科治疗的回顾性队列研究
- Author:
Chen WEN
1
,
2
;
Fang ZHU
1
,
2
;
Qian ZHANG
1
,
2
;
Chen HU
3
;
Hao CHEN
1
,
2
;
Lisheng QIU
1
,
2
;
Guocheng SHI
1
,
2
;
Hao ZHANG
1
,
2
;
Zhongqun ZHU
1
,
2
;
Huiwen CHEN
1
,
2
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Children'
2. s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, P.R.China
3. Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, P.R.China
- Publication Type:Journal Article
- Keywords:
Total anomalous pulmonary venous connection;
sutureless technique;
surgery;
treatment;
complications;
pulmonary venous obstruction
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(05):510-514
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the outcomes of sutureless technique and conventional technique in the surgical repair for infracardiac total anomalous pulmonary venous connection (TAPVC). Methods The clinical data of 46 consecutive patients with infracardiac TAPVC undergoing surgical repair in our hospital between June 2014 and April 2019 were retrospectively analyzed. Patients with combined congenital cardiac anomalies such as single ventricle and tetralogy of Fallot were excluded. Patients were divided into a conventional technique group and a sutureless technique group according to the surgical techniques. There were 35 patients in the conventional technique group, including 28 males (80.0%) and 7 females (20.0%) with a median age of 21 (8, 42) d and a median weight of 3.6 (3.0, 4.0) kg. There were 11 patients in the sutureless technique group, including 8 males (72.7%) and 3 females (27.3%) with a median age of 14 (6, 22) d and a median weight of 3.5 (2.9, 3.6) kg. The curative effect of the two groups was compared. Results There were 5 deaths (10.9%) in the conventional technique group, including 4 in-hospital deaths (8.7%) and 1 late death (2.2%). Overall mortality of the conventional technique group (14.3%, 5/35) was higher than that of the sutureless technique group (0.0%, 0/11), although the difference was not statistically significant (P=0.317). Cox regression analysis showed that sex (P=0.042), age at repair (P=0.028), cardiopulmonary bypass time (P=0.007), aortic cross-clamping time (P=0.018) and duration of ventilation (P=0.042) were risk factors for postoperative mortality. The median follow-up was 18.00 (5.00, 37.75) months. Postoperative pulmonary venous obstruction occurred in 22 patients of the conventional technique group, which was significantly more than that of the sutureless technique group (P=0.000). Conclusion For infracardiac TAPVC, sutureless technique can reduce the incidence of postoperative pulmonary venous obstruction compared with conventional technique.
