Treatment of supracardiac total anomalous pulmonary venous connection in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Shan , SHI Tao , LV Xiaodong , YAN Jun ,  LI Shoujun ,  HUA Zhongdong

Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding author：

LI Shoujun, Email: drlishoujun@yahoo.com; HUA Zhongdong, Email: richardhua@yahoo.com

Keywords：

Total anomalous pulmonary venous connection; supracardiac subtype; pulmonary vein obstruction

DOI：

10.7507/1007-4848.202012091

Video：

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Objective To analyze the surgical results of patients with supracardiac total anomalous pulmonary venous connection (TAPVC) in a single pediatric cardiac center.Methods A retrospective study was conducted on 98 pediatric patients with supracardiac TAPVC receiving surgical repair from 2014 to 2019 in our center. There were 64 males and 34 females with a median surgical age of 3.0 (1.5, 7.0) months and a median weight of 5.0 (4.0, 6.0) kg. Twenty-three (23.5%) patients had preoperative pulmonary vein obstruction. Ninety-two (93.9%) patients received conventional surgical repair, while six (6.1%) patients were treated with the sutureless technique. The Cox regression model was used to analyze the data.Results The median follow-up time was 26.50 (5.75, 44.25) months. There were 9 (9.2%) deaths. Lower weight at the time of repair (P=0.013) and prolonged cardiopulmonary bypass time (P=0.007) were associated with mortality. Postoperative pulmonary vein obstruction was observed in 8 (8.2%) patients. Associated risk factors for postoperative pulmonary vein obstruction included lower weight at the time of repair (P=0.042) and prolonged cardiopulmonary bypass time (P=0.002).Conclusion Surgical repair of supracardiac TAPVC has achieved satisfactory results in our center. Risk factors such as lower weight at the time of repair and prolonged cardiopulmonary bypass time are associated with a poor prognosis.

Citation： WANG Shan, SHI Tao, LV Xiaodong, YAN Jun, LI Shoujun, HUA Zhongdong. Treatment of supracardiac total anomalous pulmonary venous connection in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(1): 85-89. doi: 10.7507/1007-4848.202012091 Copy

1.	Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol, 2002, 39(12): 1890-1900.
2.	Seale AN, Uemura H, Webber SA, et al. Total anomalous pulmonary venous connection: Morphology and outcome from an international population-based study. Circulation, 2010, 122(25): 2718-2726.
3.	Shi G, Zhu Z, Chen J, et al. Total anomalous pulmonary venous connection: The current management strategies in a pediatric cohort of 768 patients. Circulation, 2017, 135(1): 48-58.
4.	Shi G, Zhu F, Wen C, et al. Single-institution outcomes of surgical repair of infracardiac total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 2021, 161(4): 1408-1417.
5.	Sakamoto T, Nagashima M, Umezu K, et al. Long-term outcomes of total correction for isolated total anomalous pulmonary venous connection: Lessons from 50-years' experience. Interact Cardiovasc Thorac Surg, 2018, 27(1): 20-26.
6.	Harada T, Nakano T, Oda S, et al. Surgical results of total anomalous pulmonary venous connection repair in 256 patients. Interact Cardiovasc Thorac Surg, 2019, 28(3): 421-426.
7.	Smallhorn JF, Burrows P, Wilson G, et al. Two-dimensional and pulsed Doppler echocardiography in the postoperative evaluation of total anomalous pulmonary venous connection. Circulation, 1987, 76(2): 298-305.
8.	Hoashi T, Kagisaki K, Kurosaki K, et al. Intrinsic obstruction in pulmonary venous drainage pathway is associated with poor surgical outcomes in patients with total anomalous pulmonary venous connection. Pediatr Cardiol, 2015, 36(2): 432-437.
9.	White BR, Ho DY, Faerber JA, et al. Repair of total anomalous pulmonary venous connection: Risk factors for postoperative obstruction. Ann Thorac Surg, 2019, 108(1): 122-129.
10.	Latson LA, Prieto LR. Congenital and acquired pulmonary vein stenosis. Circulation, 2007, 115(1): 103-108.
11.	Seale AN, Uemura H, Webber SA, et al. Total anomalous pulmonary venous connection: Outcome of postoperative pulmonary venous obstruction. J Thorac Cardiovasc Surg, 2013, 145(5): 1255-1262.
12.	Lo Rito M, Gazzaz T, Wilder T, et al. Repair type influences mode of pulmonary vein stenosis in total anomalous pulmonary venous drainage. Ann Thorac Surg, 2015, 100(2): 654-662.
13.	Masaki N, Adachi O, Katahira S, et al. Progression of vascular remodeling in pulmonary vein obstruction. J Thorac Cardiovasc Surg, 2020, 160(3): 777-790.
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.

1. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol, 2002, 39(12): 1890-1900.
2. Seale AN, Uemura H, Webber SA, et al. Total anomalous pulmonary venous connection: Morphology and outcome from an international population-based study. Circulation, 2010, 122(25): 2718-2726.
3. Shi G, Zhu Z, Chen J, et al. Total anomalous pulmonary venous connection: The current management strategies in a pediatric cohort of 768 patients. Circulation, 2017, 135(1): 48-58.
4. Shi G, Zhu F, Wen C, et al. Single-institution outcomes of surgical repair of infracardiac total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 2021, 161(4): 1408-1417.
5. Sakamoto T, Nagashima M, Umezu K, et al. Long-term outcomes of total correction for isolated total anomalous pulmonary venous connection: Lessons from 50-years' experience. Interact Cardiovasc Thorac Surg, 2018, 27(1): 20-26.
6. Harada T, Nakano T, Oda S, et al. Surgical results of total anomalous pulmonary venous connection repair in 256 patients. Interact Cardiovasc Thorac Surg, 2019, 28(3): 421-426.
7. Smallhorn JF, Burrows P, Wilson G, et al. Two-dimensional and pulsed Doppler echocardiography in the postoperative evaluation of total anomalous pulmonary venous connection. Circulation, 1987, 76(2): 298-305.
8. Hoashi T, Kagisaki K, Kurosaki K, et al. Intrinsic obstruction in pulmonary venous drainage pathway is associated with poor surgical outcomes in patients with total anomalous pulmonary venous connection. Pediatr Cardiol, 2015, 36(2): 432-437.
9. White BR, Ho DY, Faerber JA, et al. Repair of total anomalous pulmonary venous connection: Risk factors for postoperative obstruction. Ann Thorac Surg, 2019, 108(1): 122-129.
10. Latson LA, Prieto LR. Congenital and acquired pulmonary vein stenosis. Circulation, 2007, 115(1): 103-108.
11. Seale AN, Uemura H, Webber SA, et al. Total anomalous pulmonary venous connection: Outcome of postoperative pulmonary venous obstruction. J Thorac Cardiovasc Surg, 2013, 145(5): 1255-1262.
12. Lo Rito M, Gazzaz T, Wilder T, et al. Repair type influences mode of pulmonary vein stenosis in total anomalous pulmonary venous drainage. Ann Thorac Surg, 2015, 100(2): 654-662.
13. Masaki N, Adachi O, Katahira S, et al. Progression of vascular remodeling in pulmonary vein obstruction. J Thorac Cardiovasc Surg, 2020, 160(3): 777-790.
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.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Treatment of supracardiac total anomalous pulmonary venous connection in a single center

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