Risk factors for postoperative pulmonary venous obstruction after correction of total anomalous pulmonary venous connection
10.3760/cma.j.cn112434-20200225-00073
- VernacularTitle:完全性肺静脉异位引流术后肺静脉狭窄的危险因素分析
- Author:
Jun MAO
1
;
Yaoqiang XU
;
Lei LI
;
Aijun LIU
;
Yan CHEN
;
Yan HE
;
Xiangming FAN
;
Yinglong LIU
;
Junwu SU
Author Information
1. 首都医科大学附属北京安贞医院小儿心脏中心 北京市心肺血管疾病研究所 100029
- Keywords:
Congenital heart disease;
Total anomalous pulmonary venous connection;
Pulmonary vein obstruction;
Risk factors
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2021;37(11):669-672
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for postoperative pulmonary venous obstruction after correction of total anomalous pulmonary venous connection(TAPVC).Methods:We retrospectively reviewed all patients undergoing operative repair of TAPVC in our institution from December 2013 to January 2018. Patients with functionally univentricular circulations or atrial isomerism were excluded. Patients were divided into two groups according to whether there was pulmonary vein obstruction. The clinical variables of the two groups were compared. Variables for the multivariable analysis were chosen if there was statistical significance on univariable analysis.Results:145 patients were included, 91(63%) males, aged 4(2, 8)months and weight 5.5(4.5, 7.5)kg. Mean follow-up interval was(51±23) months. Postoperative obstruction developed in 27 patients(18.6%). The differences of anatomic type[supracardiac 18(67%) vs.59(50%), cardiac 4(15%) vs. 50(42%), infracardiac 3(11%) vs. 1(1%), mixed 2(7%) vs. 8(7%), P=0.003], preoperative obstruction[yes 19(70%) vs. 37(31%), no 8(30%) vs. 81(69%), P<0.001], associated cardiac lesions[yes 13(48%) vs. 27(23%), no 14(52%) vs. 91(77%), P=0.008] and bypass time[109(89, 129)min vs. 88(70, 110)min, P=0.002] between two groups were statistical significant. A multivariable model showed preoperative obstruction( P<0.001) and bypass time( P=0.009) were associated with postoperative obstruction. Conclusion:The incidence of pulmonary vein obstruction after correction of TAPVC was still high. If there was preoperative obstruction, or the bypass time was too long during operation, the surveillance of pulmonary vein obstruction should be strengthened after operation.
