Objective To analyze risk factors for pulmonary vein obstruction(PVO) after cardiac-type total anomalous pulmonary venous connection (TAPVC) repair. Methods A retrospective analysis of clinical and echocardiography data of 169 patients with cardiac-type TAPVC who underwent surgery at our center from April 2009 to April 2019 was conducted. Kaplan-Meier curves were used to assess the risk of postoperative pulmonary vein obstruction. Logistic regression analysis was used to identify relevant risk factor for postoperative pulmonary vein obstruction. ResultsThe median age at surgery was 89 days, and the median weight at surgery was 4.8 kg. Post-repair pulmonary vein obstruction occurred in 8.9% (15/169) of cases. The subtype of coronary sinus/right atrium did not significantly affect the risk of PPVO (P=0.33). Relevant risk factors included preoperative pulmonary vein obstruction (P<0.001) and the ratio of left ventricular end-diastolic diameter to right ventricular diameter (P=0.025). ConclusionSurgical repair of cardiac-type TAPVC has achieved satisfactory results in our center, but the long-term risk of obstruction should not be underestimated. An increased ratio of left ventricular end-diastolic diameter to right ventricular diameter and preoperative pulmonary vein obstruction were associated with post-repair pulmonary vein obstruction.