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Long-term outcomes of repair in children with total anomalous pulmonary venous connection

Published online by Cambridge University Press:  27 May 2024

Zhangwei Wang Open the ORCID record for Zhangwei Wang [Opens in a new window] ,
Kai Ma  and
Shoujun Li
Zhangwei Wang
Affiliation:
Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China Department of Cardiac Surgery, Beijing Children’s Hospital, Capital Medical University, National Children’s Medical Center, Beijing, China
Kai Ma
Affiliation:
Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
Shoujun Li*
Affiliation:
Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
*
Corresponding author: S. Li; Email: drlishoujunfw@163.com
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Abstract

Objectives:

The clinical data of patients with total anomalous pulmonary venous connection who underwent repair in our centre in the past 13 years were reviewed. In this study, we systemically reviewed our experience in the optimal surgical strategy for patients with total anomalous pulmonary venous connection, aiming to provide evidence for clinical decision-making.

Methods:

From January 1, 2009, to December 31, 2021, 122 patients undergoing surgical treatment for total anomalous pulmonary venous connection in our hospital were enrolled. Among them, 18 patients with single ventricle repair were excluded from the study. Multivariate analysis was used to determine the risk factors for early and late death and the risk factors for pulmonary vein obstruction.

Results:

There were 64 males and 40 females. The median age at surgery was 107 days (range, 25 days–788 days), the median weight at surgery was 4.8 kg (range, 3 kg–22 kg), and the median follow-up was 59 months (range, 0–150 months). Seven patients died early after surgery and six died late after discharge. Multivariable analysis indicated that prolonged cardiopulmonary bypass time was the only independent risk factor for early postoperative mortality. Multivariate analysis did not identify risk factors for late death. Emergency surgery, preoperative moderate and severe pulmonary hypertension, and prolonged cardiopulmonary bypass time were independent risk factors for postoperative pulmonary vein obstruction.

Conclusion:

Early and long-term late outcomes of repair in patients with total anomalous pulmonary venous connection have been encouraging. Postoperative pulmonary vein obstruction remains a major problem for specialists worldwide. Pulmonary vein obstruction should be considered in children with preoperative emergency surgery, moderate to severe pulmonary hypertension and prolonged cardiopulmonary bypass time, and regular follow-up is necessary.

Keywords

CHDtotal anomalous pulmonary venous connectionpulmonary vein obstructionrepair
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 9 , September 2024 , pp. 1961 - 1970
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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