Korean J Thorac Cardiovasc Surg.  2016 Oct;49(5):337-343. 10.5090/kjtcs.2016.49.5.337.

Outcomes of Surgery for Total Anomalous Pulmonary Venous Return without Total Circulatory Arrest

• Lee Y
• Cho JY
• Kwon OY
• Jang WS

• KMID: 2354366
• DOI: http://doi.org/10.5090/kjtcs.2016.49.5.337

Abstract

BACKGROUND
Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair. However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation. We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes.
METHODS
We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015. All patients were newborns or infants who underwent in situ TAPVR repair without TCA.
RESULTS
Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%). The median follow-up period for all patients was 42.9 months. Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO). Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality.
CONCLUSION
In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes. Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair.

Keyword

Congenital heart disease (CHD); Total anomalous pulmonary venous return; Total circulatory arrest

MeSH Terms

Follow-Up Studies
Humans
Infant
Infant, Newborn
Mortality
Reoperation
Retrospective Studies
Risk Factors
Scimitar Syndrome*
Ventilators, Mechanical