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Long-term outcomes of individualised repair in patients with primary pulmonary vein stenosis

Published online by Cambridge University Press:  18 February 2025

Zhangwei Wang Open the ORCID record for Zhangwei Wang [Opens in a new window]  and
Yang Yang
Zhangwei Wang*
Affiliation:
Department of Cardiac Surgery, Beijing Children’s Hospital, National Children’s Medical Center, Capital Medical University, Beijing, China
Yang Yang
Affiliation:
Department of Cardiac Surgery, Beijing Children’s Hospital, National Children’s Medical Center, Capital Medical University, Beijing, China
*
Correspondence author: Zhangwei Wang; Email: [email protected]
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Abstract

Objectives:

Primary pulmonary vein stenosis is a rare congenital heart condition and carries a poor prognosis. Various surgical techniques have been introduced to treat primary pulmonary vein stenosis. However, there is no consensus on the optimal approach. This study aimed to evaluate the outcomes of surgical treatment of primary pulmonary vein stenosis, identify the risk factors for pulmonary vein restenosis and reintervention, and determine the optimal strategy for primary pulmonary vein stenosis repair.

Methods:

From December 2008 to December 2023, 64 patients with primary pulmonary vein stenosis undergoing surgical repair in our institution were included [non-sutureless group, n = 42; sutureless group, n = 22]. The Cox proportional hazard model was used to identify risk factors for pulmonary vein restenosis and pulmonary vein restenosis-related reintervention.

Results:

There were three in-hospital deaths and one late death. The survival rates at 1, 5, and 15 years were 91.9%, 84.2%, and 69.8%, respectively, in the whole cohort. Compared with the non-sutureless group, the sutureless group did not significantly improve the long-term survival of primary pulmonary vein stenosis patients (P = 0.484). Pulmonary vein restenosis occurred in 15 patients. Multivariable analysis showed that Involvement of the left inferior pulmonary vein (P < 0.001) was the only independent risk factor for pulmonary vein restenosis, while sutureless repair (P = 0.037) was a protective factor. Pulmonary vein restenosis-related reintervention occurred in 12 patients. On multivariate analysis, three or four pulmonary veins involvement (P = 0.001) and preoperative severity score exceeding 5 (P = 0.050) were found to be independent risk factors associated with pulmonary vein restenosis-related reintervention; however, sutureless repair (P = 0.021) was a protective factor.

Conclusions:

Management of infants with primary pulmonary vein stenosis is challenging. Surgical repair of primary pulmonary vein stenosis can be safely achieved using different techniques, with similar long-term mortality. Compared with non-sutureless repair, sutureless repair was significantly associated with decreased pulmonary vein restenosis and decreased pulmonary vein restenosis-related reintervention, respectively. Preoperative severity score exceeding 5, 3, or 4 pulmonary veins involvement, and left inferior pulmonary vein involvement are independent risk factors for adverse outcomes.

Keywords

primary pulmonary vein stenosispulmonary vein restenosissuturelessreinterventionrisk factor
Type
Research Article
Information
Cardiology in the Young , First View , pp. 1 - 10
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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Footnotes

†

Wang Zhangwei and Yang Yang contributed equally to this manuscript.

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