Surgical Outcomes of Supracardiac Total Anomalous Pulmonary Venous Connection in 132 Patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GETong-kai ¹ , OUYan-qiu ² , DINGYi-qun ¹ , NIEZhi-qiang ² , LIUXiao-qing ² , WENShu-sheng ¹ , CENJian-zheng ¹ , LUODan-dong ¹ ,  CHENJi-mei ¹

1. Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, P. R. China;
2. Epidemiological Research Office, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangzhou 510100, P. R. China;

Corresponding author：

CHENJi-mei, Email: jimei1965@gmail.com

Keywords：

Congenital heart disease; Total anomalous pulmonary venous connection; Sutureless technique

DOI：

10.7507/1007-4848.20140222

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze clinical outcomes of sutureless technique for patients undergoing surgical correction of total anomalous pulmonary venous connection (TAPVC). Methods Between July 2007 and December 2013, 132 consecutive TAPVC patients underwent surgical correction in Guangdong Cardiovascular Institute. Those patients with such associated congenital cardiac anomalies as single ventricle and right atrial isomerism were excluded from this study. All the patients underwent biventricular repair. Preoperatively, all the patients received echocardiography, and most patients received CT scan to know the development of pulmonary veins. Preoperative diagnosis was confirmed by intraoperative exploration. According to different surgical techniques, all the patients were divided to a conventional technique group and a sutureless technique group. In the conventional technique group, there were 69 patients including 54 males (78.3%)and 15 females (21.7%)with their median age of 60 (30, 225)days and median body weight of 4.85 (3.50, 6.35)kg. In the sutureless technique group, there were 63 patients including 48 males (76.20%)and 15 females (23.8%)with their median age of 90 (30, 210)days and median body weight of 4.58 (3.72, 6.20)kg. Follow-up was performed till January 1, 2014. Results In-hospital mortality (4.8% vs. 7.2%, χ²=1.414, P=0.720)and postoperative overall mortality (4.8% vs. 13.0%, χ²=2.733, P=0.098)of the sutureless technique group were both lower than those of the conventional technique group, although there was no statistical difference. Postoperative incidence of pulmonary venous obstruction (PVO)of the sutureless technique group was significantly lower than that of the conventional technique group (1.6% vs. 10.1%, χ²=4.236, P=0.040). Cox proportional-hazards regression showed that conventional technique and preoperative PVO were significant risk factors for postoperative PVO (P=0.023, P=0.016). Conventional technique was not significantly correlated with postoperative mortality (P=0.060). Conclusion Sutureless technique can significantly lower postoperative incidence of PVO for patients with supracardiac TAPVC.

Citation： GETong-kai, OUYan-qiu, DINGYi-qun, NIEZhi-qiang, LIUXiao-qing, WENShu-sheng, CENJian-zheng, LUODan-dong, CHENJi-mei. Surgical Outcomes of Supracardiac Total Anomalous Pulmonary Venous Connection in 132 Patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(6): 774-778. doi: 10.7507/1007-4848.20140222 Copy

1.	丁以群, 庄建, 陈寄梅, 等.应用无内膜接触缝合技术治疗心上型全肺静脉异位引流.中华胸心血管外科杂志, 2010, 26(2):73-75.
2.	Karamlou T, Gurofsky R, Al Sukhni E, et al. Factors associated with mortality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation, 2007, 115(12):1591-1598.
3.	陈林, 肖颖彬, 王学锋, 等.完全性肺静脉异位引流的外科治疗.中国胸心血管外科临床杂志, 2004, 11(2):147-148.
4.	徐志伟, 苏肇伉, 丁文祥, 等. 787例小于6月龄先天性心脏病患者外科治疗的临床分析.中国胸心血管外科临床杂志, 2005, 12(2):69-72.
5.	Husain SA, Maldonado E, Rasch D, et al. Total anomalous pulmonary venous connection:factors associated with mortality and recurrent pulmonary venous obstruction. Ann Thorac Surg, 2012, 94(3):825-832.
6.	Lacour-Gayet F. Surgery for pulmonary venous obstruction after repair of total anomalous pulmonary venous return. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006:45-50.
7.	Hancock Friesen CL, Zurakowski D, Thiagarajan RR, et al. Total anomalous pulmonary venous connection:an analysis of current management strategies in a single institution. Ann Thorac Surg, 2005, 79(2):596-606.
8.	Kelle AM, Backer CL, Gossett JG, et al. Total anomalous pulmonary venous connection:results of surgical repair of 100 patients at a single institution. J Thorac Cardiovasc Surg, 2010, 139(6):1387-1394.
9.	Kirshbom PM, Myung RJ, Gaynor JW, et al. Preoperative pulmonary venous obstruction affects long-term outcome for survivors of total anomalous pulmonary venous connection repair. Ann Thorac Surg, 2002, 74(5):1616-1620.
10.	Yee ES, Turley K, Hsieh WR, et al. Infant total anomalous pulmonary venous connection:factors influencing timing of presentation and operative outcome. Circulation, 1987, 76(3 Pt 2):Ⅲ83-Ⅲ87.
11.	Yun T, Coles JG, Konstantinov IE, et al. Conventional and sutureless techniques for management of the pulmonary veins:Evolution of indications from postrepair pulmonary vein stenosis to primary pulmo-nary vein anomalies. J Thorac Cardiovasc Surg, 2005, 129(1):167-174.
12.	Lupinetti FM, Kulik TJ, Beekman RH 3rd, et al. Correction of total anomalous pulmonary venous connection in infancy. J Thorac Cardiovasc Surg, 1993, 106(5):880-885.
13.	Kanter KR. Surgical repair of total anomalous pulmonary venous connection. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006:40-44.
14.	Lacour-Gayet F, Zoghbi J, Serraf AE, et al. Surgical management of progressive pulmonary venous obstruction after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 1999, 117(4):679-687.
15.	Kirshbom PM, Myung RJ, Gaynor JW, et al. Preoperative pulmonary venous obstruction affects long-term outcome for survivors of total anomalous pulmonary venous connection repair. J Thorac Cardiovasc Surg, 2002, 74(5):1616-1620.
16.	Yamashita K, Hoashi T, Kagisaki K, et al. Midterm outcomes of sutureless technique for postoperative pulmonary venous stenosis. Gen Thorac Cardiovasc Surg, 2014, 62(1):48-52.
17.	Caldarone CA. "Sutureless" pulmonary vein stenosis repair. The Cardiothoracic Surgery Network. Clinical resources:congenital ardiac expert technique. Accessed January 16, 2009.
18.	Yanagawa B, Alghamdi AA, Dragulescu A, et al. Primary sutureless repair for "simple" total anomalous pulmonary venous connection:Midterm results in a single institution. J Thorac Cardiovasc Surg, 2011, 141(6):1346-1354.
19.	Yun T, Al-Radi OO, Adatia I, et al. Contemporary management of right atrial isomerism:effect of evolving therapeutic strategies. J Thorac Cardiovasc Surg, 2006, 131(5):1108-1113.
20.	Honjo O, Atlin CR, Hamilton BC, et al. Primary sutureless repair for infants with mixed total anomalous pulmonary venous drainage. Ann Thorac Surg, 2010, 90(3):862-868.

1. 丁以群, 庄建, 陈寄梅, 等.应用无内膜接触缝合技术治疗心上型全肺静脉异位引流.中华胸心血管外科杂志, 2010, 26(2):73-75.
2. Karamlou T, Gurofsky R, Al Sukhni E, et al. Factors associated with mortality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation, 2007, 115(12):1591-1598.
3. 陈林, 肖颖彬, 王学锋, 等.完全性肺静脉异位引流的外科治疗.中国胸心血管外科临床杂志, 2004, 11(2):147-148.
4. 徐志伟, 苏肇伉, 丁文祥, 等. 787例小于6月龄先天性心脏病患者外科治疗的临床分析.中国胸心血管外科临床杂志, 2005, 12(2):69-72.
5. Husain SA, Maldonado E, Rasch D, et al. Total anomalous pulmonary venous connection:factors associated with mortality and recurrent pulmonary venous obstruction. Ann Thorac Surg, 2012, 94(3):825-832.
6. Lacour-Gayet F. Surgery for pulmonary venous obstruction after repair of total anomalous pulmonary venous return. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006:45-50.
7. Hancock Friesen CL, Zurakowski D, Thiagarajan RR, et al. Total anomalous pulmonary venous connection:an analysis of current management strategies in a single institution. Ann Thorac Surg, 2005, 79(2):596-606.
8. Kelle AM, Backer CL, Gossett JG, et al. Total anomalous pulmonary venous connection:results of surgical repair of 100 patients at a single institution. J Thorac Cardiovasc Surg, 2010, 139(6):1387-1394.
9. Kirshbom PM, Myung RJ, Gaynor JW, et al. Preoperative pulmonary venous obstruction affects long-term outcome for survivors of total anomalous pulmonary venous connection repair. Ann Thorac Surg, 2002, 74(5):1616-1620.
10. Yee ES, Turley K, Hsieh WR, et al. Infant total anomalous pulmonary venous connection:factors influencing timing of presentation and operative outcome. Circulation, 1987, 76(3 Pt 2):Ⅲ83-Ⅲ87.
11. Yun T, Coles JG, Konstantinov IE, et al. Conventional and sutureless techniques for management of the pulmonary veins:Evolution of indications from postrepair pulmonary vein stenosis to primary pulmo-nary vein anomalies. J Thorac Cardiovasc Surg, 2005, 129(1):167-174.
12. Lupinetti FM, Kulik TJ, Beekman RH 3rd, et al. Correction of total anomalous pulmonary venous connection in infancy. J Thorac Cardiovasc Surg, 1993, 106(5):880-885.
13. Kanter KR. Surgical repair of total anomalous pulmonary venous connection. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006:40-44.
14. Lacour-Gayet F, Zoghbi J, Serraf AE, et al. Surgical management of progressive pulmonary venous obstruction after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 1999, 117(4):679-687.
15. Kirshbom PM, Myung RJ, Gaynor JW, et al. Preoperative pulmonary venous obstruction affects long-term outcome for survivors of total anomalous pulmonary venous connection repair. J Thorac Cardiovasc Surg, 2002, 74(5):1616-1620.
16. Yamashita K, Hoashi T, Kagisaki K, et al. Midterm outcomes of sutureless technique for postoperative pulmonary venous stenosis. Gen Thorac Cardiovasc Surg, 2014, 62(1):48-52.
17. Caldarone CA. "Sutureless" pulmonary vein stenosis repair. The Cardiothoracic Surgery Network. Clinical resources:congenital ardiac expert technique. Accessed January 16, 2009.
18. Yanagawa B, Alghamdi AA, Dragulescu A, et al. Primary sutureless repair for "simple" total anomalous pulmonary venous connection:Midterm results in a single institution. J Thorac Cardiovasc Surg, 2011, 141(6):1346-1354.
19. Yun T, Al-Radi OO, Adatia I, et al. Contemporary management of right atrial isomerism:effect of evolving therapeutic strategies. J Thorac Cardiovasc Surg, 2006, 131(5):1108-1113.
20. Honjo O, Atlin CR, Hamilton BC, et al. Primary sutureless repair for infants with mixed total anomalous pulmonary venous drainage. Ann Thorac Surg, 2010, 90(3):862-868.

Previous Article
Hypotheses of Potential Mechanisms of Cancer Stem Cell in Peritoneal Metastasis of Gastric Cancer
Next Article
Advances of Lymphocinesia in The Abdominal Cavity Infection

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Surgical Outcomes of Supracardiac Total Anomalous Pulmonary Venous Connection in 132 Patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content