Risk Factors for Prolonged Ventilation after Total Anomalous Pulmonary Venous Connection (TAPVC) Operation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HEYan ,  LIUYing-long , SUJun-wu , CHENGPei , CHENYan

Department of Pediatric Cardiology Surgery and Intensive Care Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding author：

LIUYing-long, Email: hybicq@qq.com

Keywords：

Heart defects; Congenital disease; Total anomalous pulmonary venous drainage; Mechanical ventilation; Risk factors

DOI：

10.7507/1007-4848.20160033

Video：

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Objective To investigate the risk factors for prolonged postoperative mechanical ventilation patients with total anomalous pulmonary venous connection (TAPVC). Methods We retrospectively analyzed the clinical data of 97 survived TAPVC patients in our hospital between June 2011 and December 2013. There were 55 males and 42 females with age of 4.4 (2, 12) months. The patients ventilated longer than mean time were as a prolonged ventilated group (n=50) and the others as a normal group (n=47). Perioperative variables between the two groups were compared and selected, then put into logistic regression analysis. Results For the 97 survived patients, the mean ventilation time is 49 (25, 90) hours. Age, weight, pre-operative left ventricular end-diastolic dimension, atrial septal defect (ASD) caliber, inotropic drug dosage, postoperative left ventricular end-diastolic dimension, maximum pulmonary venous velocity (P < 0.01), and cardio-pulmonary bypass (CPB) time (P < 0.05) were statistically different between the two groups. In logistic regress analysis, age (OR=0.804 with 95%CI 0.71 to 0.91) and maximum pulmonary venous velocity (OR=1.016 with 95%CI 1.00 to 1.03) were risk factors for prolonged postoperative mechanical ventilation. Conclusion Age and maximum pulmonary venous velocity are the risk factors associated with prolonged postoperative mechanical ventilation in patients with TAPVC.

Citation： HEYan, LIUYing-long, SUJun-wu, CHENGPei, CHENYan. Risk Factors for Prolonged Ventilation after Total Anomalous Pulmonary Venous Connection (TAPVC) Operation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(2): 147-150. doi: 10.7507/1007-4848.20160033 Copy

1.	Hirsch JC, Bove EL. Total anomalous venous connection. Multimed Man Cardiothorac Surg, 2007, 2007(507): mmcts. 2006. 002253. doi: 10. 1510/mmcts. 2006. 002253.
2.	Sano S, Brawn WJ, Mee RB. Total anomalous pulmonary venous drainage. J Throrac Cardiovasc Surg, 1989, 97(6): 886-892.
3.	Anil Kumar D, Kumar RN, Narasinga Rao P, et al. Repair of total anomalous pulmonary venous connection in early infancy. Asian Cardiovasc Thorac Ann, 2003, 11(1):18-22.
4.	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.
5.	李守军, 王维, 郑哲, 等. 婴儿期完全性肺静脉畸形引流矫治术近期疗效分析. 中华外科杂志, 2010, 48(10): 731-733.
6.	Whight CM, Barratt-Boyes BG, Calder AL, et al. Total anomalous pulmonary venous connection: long-term results following repair in infancy. J Thorac Cardiovasc Surg, 1978, 75(1): 52-63.
7.	Van de Wal HJ, Hamilton DI, Godman MJ, et al. Pulmonary venous obstruction following correction for total anomalous pulmonary venous drainage:a challenge. Eur J Cardio-thorac Surg, 1992, 6(10): 545-549.
8.	Ricci M, Elliott M, Cohen GA, et al. Management of pulmonary venous obstruction after correction of TAPVC: risk factors for adverse outcome. Eur J Cardiol-thorac Surg, 2003, 24(1): 28-36.
9.	李建荣, 刘迎龙. 完全性肺静脉畸形引流术后肺静脉梗阻. 中华胸心血管外科杂志, 2006, 22(5): 351-353.
10.	葛同开,欧艳秋,丁以群,等. 心上型完全性肺静脉异位引流手术132例的治疗效果分析. 中国胸心血管外科临床杂志, 2014, 21(6): 774-778.
11.	罗凯, 郑景浩. 心上路径矫治新生儿期完全性肺静脉异位引流.中国胸心血管外科临床杂志, 2015, 22(2): 165-167.
12.	Jinghao Z, Botao G, Zhiwei X, et al. The research on operation of obstructed total anomalous pulmonary venous connection in neonates. Scientific World Journal, 2014, 2014:576569. doi: 10.1155/2014/576569. Epub 2014 Jun 26.
13.	Okonta KE, Agarwal V, Abubakar U. Superior repair: a useful approach for some anatomic variants of total anomalous pulmonary venous connection. Afr J Paediatr Surg, 2013, 10(2):131-134.
14.	Li W, Rosenbruch M, Pauluhn J. Effect of PEEP on phosgene-induced lung edema: Pilot study on dogs using protective ventilation strategies. Exp Toxicol Pathol, 2015, 67(2): 109-116.
15.	Cui Q, Zhou H, Zhao R, et al. The effects of open lung ventilation on respiratory mechanics and haemodynamics in atelectatic infants after cardiopulmonary bypass. J Int Med Res, 2009, 37(1): 113-120.
16.	Laks H, Standeven J, Blair O, et al. The effects of cardiopulmonary bypass with crystalloid and colloid hemodilution on myocardial extravascular water. J Thorac Cardiovasc Surg, 1977, 73(1): 129-138.
17.	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.
18.	St Louis JD, Harvey BA, Menk JS, et al. Repair of simple total anomalous pulmonary venous connection: A review from the pediatric cardiac care consortium. Ann Thorac Surg, 2012, 94(1): 133-137.
19.	Serraf A, Bruniaux J, Lacour-Gayet F, et al. Obstruction of total anomalous pulmonary venous drainage return.Toward neutraliza-tion of a major risk factor. J Throrac Cardiovasc Surg, 1991, 101(4): 601-606.
20.	Kirshbom PM, Flynn TB, Clancy RR, et al. Late neurodevelopmental outcome after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 2005, 129(5): 1091-1097.

1. Hirsch JC, Bove EL. Total anomalous venous connection. Multimed Man Cardiothorac Surg, 2007, 2007(507): mmcts. 2006. 002253. doi: 10. 1510/mmcts. 2006. 002253.
2. Sano S, Brawn WJ, Mee RB. Total anomalous pulmonary venous drainage. J Throrac Cardiovasc Surg, 1989, 97(6): 886-892.
3. Anil Kumar D, Kumar RN, Narasinga Rao P, et al. Repair of total anomalous pulmonary venous connection in early infancy. Asian Cardiovasc Thorac Ann, 2003, 11(1):18-22.
4. 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.
5. 李守军, 王维, 郑哲, 等. 婴儿期完全性肺静脉畸形引流矫治术近期疗效分析. 中华外科杂志, 2010, 48(10): 731-733.
6. Whight CM, Barratt-Boyes BG, Calder AL, et al. Total anomalous pulmonary venous connection: long-term results following repair in infancy. J Thorac Cardiovasc Surg, 1978, 75(1): 52-63.
7. Van de Wal HJ, Hamilton DI, Godman MJ, et al. Pulmonary venous obstruction following correction for total anomalous pulmonary venous drainage:a challenge. Eur J Cardio-thorac Surg, 1992, 6(10): 545-549.
8. Ricci M, Elliott M, Cohen GA, et al. Management of pulmonary venous obstruction after correction of TAPVC: risk factors for adverse outcome. Eur J Cardiol-thorac Surg, 2003, 24(1): 28-36.
9. 李建荣, 刘迎龙. 完全性肺静脉畸形引流术后肺静脉梗阻. 中华胸心血管外科杂志, 2006, 22(5): 351-353.
10. 葛同开,欧艳秋,丁以群,等. 心上型完全性肺静脉异位引流手术132例的治疗效果分析. 中国胸心血管外科临床杂志, 2014, 21(6): 774-778.
11. 罗凯, 郑景浩. 心上路径矫治新生儿期完全性肺静脉异位引流.中国胸心血管外科临床杂志, 2015, 22(2): 165-167.
12. Jinghao Z, Botao G, Zhiwei X, et al. The research on operation of obstructed total anomalous pulmonary venous connection in neonates. Scientific World Journal, 2014, 2014:576569. doi: 10.1155/2014/576569. Epub 2014 Jun 26.
13. Okonta KE, Agarwal V, Abubakar U. Superior repair: a useful approach for some anatomic variants of total anomalous pulmonary venous connection. Afr J Paediatr Surg, 2013, 10(2):131-134.
14. Li W, Rosenbruch M, Pauluhn J. Effect of PEEP on phosgene-induced lung edema: Pilot study on dogs using protective ventilation strategies. Exp Toxicol Pathol, 2015, 67(2): 109-116.
15. Cui Q, Zhou H, Zhao R, et al. The effects of open lung ventilation on respiratory mechanics and haemodynamics in atelectatic infants after cardiopulmonary bypass. J Int Med Res, 2009, 37(1): 113-120.
16. Laks H, Standeven J, Blair O, et al. The effects of cardiopulmonary bypass with crystalloid and colloid hemodilution on myocardial extravascular water. J Thorac Cardiovasc Surg, 1977, 73(1): 129-138.
17. 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.
18. St Louis JD, Harvey BA, Menk JS, et al. Repair of simple total anomalous pulmonary venous connection: A review from the pediatric cardiac care consortium. Ann Thorac Surg, 2012, 94(1): 133-137.
19. Serraf A, Bruniaux J, Lacour-Gayet F, et al. Obstruction of total anomalous pulmonary venous drainage return.Toward neutraliza-tion of a major risk factor. J Throrac Cardiovasc Surg, 1991, 101(4): 601-606.
20. Kirshbom PM, Flynn TB, Clancy RR, et al. Late neurodevelopmental outcome after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 2005, 129(5): 1091-1097.

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