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Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes

INTRODUCTION: Total anomalous pulmonary venous connection (TAPVC) is a rare but critical cardiac anomaly, in which pulmonary veins are connected to an abnormal location rather than the left atrium. The prognosis can be extremely poor without intervention, with a mortality of 80% during infancy. The...

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Autores principales: Li, Gefei, Meng, Baoying, Zhang, Cheng, Zhang, Weimin, Zhou, Xiaodong, Zhang, Qing, Ding, Yiqun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874290/
https://www.ncbi.nlm.nih.gov/pubmed/36713670
http://dx.doi.org/10.3389/fsurg.2022.1086596
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author Li, Gefei
Meng, Baoying
Zhang, Cheng
Zhang, Weimin
Zhou, Xiaodong
Zhang, Qing
Ding, Yiqun
author_facet Li, Gefei
Meng, Baoying
Zhang, Cheng
Zhang, Weimin
Zhou, Xiaodong
Zhang, Qing
Ding, Yiqun
author_sort Li, Gefei
collection PubMed
description INTRODUCTION: Total anomalous pulmonary venous connection (TAPVC) is a rare but critical cardiac anomaly, in which pulmonary veins are connected to an abnormal location rather than the left atrium. The prognosis can be extremely poor without intervention, with a mortality of 80% during infancy. The purpose of this research is to summarize the outcomes and relevant risk factors of 80 total anomalous pulmonary venous connection (TAPVC) patients who underwent primary TAPVC sutureless repair and discuss the indications and benefits of primary sutureless repair. METHODS: This retrospective review included 80 patients with TAPVC who underwent primary sutureless repair at a single institution between January 2015 and December 2020. Patients were subdivided into 4 groups according to Darling's classification. Risk factors that increase the postoperative pulmonary vein flow velocity were explored by Multiple Linear regression. RESULTS: Anatomic TAPVC subtypes included supracardiac 35 (43.8%), cardiac 24 (30%), infracardiac 17 (21.2%), and mixed 4 (5%). Median age at repair was 16.5 days and median weight was 3.5 kg. Preoperative pulmonary venous obstruction (PVO)was presented in 20 (25%) patients. There were 2 early deaths and 1 late death. 2 patients developed postoperative PVO and none required reintervention. Prolonged cardiopulmonary bypass time (CPB) (p = 0.009), preoperative pneumonia (p = 0.022) and gender (p = 0.041) were found to be associated with the increase of postoperative pulmonary vein flow velocity. DISCUSSION: Under the primary sutureless technique, no statistical difference was observed among the 4 subgroups in terms of postoperative pulmonary vein flow velocity (p = 0.589). The primary sutureless technique may eliminate the differences between subtypes while decrease the postoperative PVO rate, which makes it applicable in any subtypes of TAPVC. Following the favorable outcomes in preventing postoperative PVO in all subtypes in this study, we advocate the indications for primary sutureless repair may expand further to all the TAPVC patients.
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spelling pubmed-98742902023-01-26 Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes Li, Gefei Meng, Baoying Zhang, Cheng Zhang, Weimin Zhou, Xiaodong Zhang, Qing Ding, Yiqun Front Surg Surgery INTRODUCTION: Total anomalous pulmonary venous connection (TAPVC) is a rare but critical cardiac anomaly, in which pulmonary veins are connected to an abnormal location rather than the left atrium. The prognosis can be extremely poor without intervention, with a mortality of 80% during infancy. The purpose of this research is to summarize the outcomes and relevant risk factors of 80 total anomalous pulmonary venous connection (TAPVC) patients who underwent primary TAPVC sutureless repair and discuss the indications and benefits of primary sutureless repair. METHODS: This retrospective review included 80 patients with TAPVC who underwent primary sutureless repair at a single institution between January 2015 and December 2020. Patients were subdivided into 4 groups according to Darling's classification. Risk factors that increase the postoperative pulmonary vein flow velocity were explored by Multiple Linear regression. RESULTS: Anatomic TAPVC subtypes included supracardiac 35 (43.8%), cardiac 24 (30%), infracardiac 17 (21.2%), and mixed 4 (5%). Median age at repair was 16.5 days and median weight was 3.5 kg. Preoperative pulmonary venous obstruction (PVO)was presented in 20 (25%) patients. There were 2 early deaths and 1 late death. 2 patients developed postoperative PVO and none required reintervention. Prolonged cardiopulmonary bypass time (CPB) (p = 0.009), preoperative pneumonia (p = 0.022) and gender (p = 0.041) were found to be associated with the increase of postoperative pulmonary vein flow velocity. DISCUSSION: Under the primary sutureless technique, no statistical difference was observed among the 4 subgroups in terms of postoperative pulmonary vein flow velocity (p = 0.589). The primary sutureless technique may eliminate the differences between subtypes while decrease the postoperative PVO rate, which makes it applicable in any subtypes of TAPVC. Following the favorable outcomes in preventing postoperative PVO in all subtypes in this study, we advocate the indications for primary sutureless repair may expand further to all the TAPVC patients. Frontiers Media S.A. 2023-01-11 /pmc/articles/PMC9874290/ /pubmed/36713670 http://dx.doi.org/10.3389/fsurg.2022.1086596 Text en © 2023 Li, Meng, Zhang, Zhang, Zhou, Zhang and Ding. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Li, Gefei
Meng, Baoying
Zhang, Cheng
Zhang, Weimin
Zhou, Xiaodong
Zhang, Qing
Ding, Yiqun
Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes
title Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes
title_full Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes
title_fullStr Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes
title_full_unstemmed Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes
title_short Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes
title_sort total anomalous pulmonary venous connection in 80 patients: primary sutureless repair and outcomes
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874290/
https://www.ncbi.nlm.nih.gov/pubmed/36713670
http://dx.doi.org/10.3389/fsurg.2022.1086596
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