Log in

Outcomes of Surgical Repair of Total Anomalous Pulmonary Venous Drainage: Role of Primary Sutureless Technique

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

To evaluate the surgical outcomes of total anomalous pulmonary venous drainage focusing on survival, postoperative and pulmonary venous obstruction. Further investigate the role of primary sutureless technique in patients with preoperative pulmonary venous obstruction. Consecutive patients underwent total anomalous pulmonary venous drainage repair in our institution during Jan 2000 to Dec 2019 were enrolled into this retrospective analysis. Since 2016, sutureless repair was regularly applied in patients with preoperative pulmonary venous obstruction. All patients with preoperative pulmonary venous obstruction referred before 2016 had underwent traditional repair. A total of 95 patients were included. During follow-up time of 85 months, main endpoints were documented in 21 patients, including 9 (9.5%) early deaths, 3 (2.3%) late deaths and 9 (9.5%) postoperative pulmonary venous obstructions. Preoperative pulmonary venous obstruction was presented in 26 (27.4%) patients with more emergent surgery (14/26 vs 3/69, P < 0.001) was required. Main endpoints occurred more in patients with preoperative pulmonary venous obstruction (4/26 vs 5/69, P = 0.004). Patients experienced sutureless technique had a lower incidence of postoperative PVO at follow-up (0/11 versus 4/11, P = 0.045). Outcomes of surgical repair for total anomalous venous drainage are satisfactory. However, preoperative pulmonary venous obstruction may be accompanying unfavorable early deaths and postoperative pulmonary venous obstruction. Propensity matching analysis showed that sutureless technique was benefit for postoperative pulmonary venous obstruction without longer cardiopulmonary bypass and aortic cross-clamp time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Karamlou T, Gurofsky R, Al Sukhni E et al (2007) Factors associated with mor- tality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation 115:1591–1598

    Article  PubMed  Google Scholar 

  2. Kanter KR (2006) Surgical repair of total anomalous pulmonary venous connection. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 9:40–44

    Article  Google Scholar 

  3. Yong MS, d’Udekem Y, Robertson T et al (2011) Outcomes of surgery for simple total anomalous pulmonary venous drainage in neonates. Ann Thorac Surg 91:1921–1927

    Article  PubMed  Google Scholar 

  4. Hancock Friesen CL, Zurakowski D, Thiagarajan RR et al (2005) Total anomalous pulmonary venous connection: an analysis of current management strategies in a single institution. Ann Thorac Surg. 79:596–606

    Article  PubMed  Google Scholar 

  5. Lacour-Gayet F, Zoghbi J, Serraf AE et al (1999) Surgical management of progressive pulmonary venous obstruction after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg. 117:679–687

    Article  CAS  PubMed  Google Scholar 

  6. Caldarone CA, Najm HK, Kadletz M, Freedom RM, Williams WG, Coles JG (1998) Relentless pulmonary vein stenosis after repair of total anomalous pulmonary venous drainage. Ann Thorac Surg 66:1514–1520

    Article  CAS  PubMed  Google Scholar 

  7. Rito Lo M, Gazzaz T, Wilder T et al (2015) Repair type influences mode of pulmonary vein stenosis in total anomalous pulmonary venous drainage. Ann Thorac Surg. 100:654–662

    Article  Google Scholar 

  8. Shi G, Zhu Z, Chen J et al (2017) Total anomalous pulmonary venous connection: the current management strategies in a pediatric cohort of 768 patients. Circulation 135:48–58

    Article  PubMed  Google Scholar 

  9. Ou-Yang WB, Zhang H, Yang KM, Li SJ (2012) Modified anastomosis for repair of supracardiac total anomalous pulmonary venous connection in infants. J Card Surg 27:387–389

    Article  PubMed  Google Scholar 

  10. St Louis JD, Harvey BA, Menk JS et al (2012) Repair of “simple” total anomalous pulmonary venous connection: a review from the pediatric cardiac care consortium. Ann Thorac Surg 94:133–138

    Article  PubMed  PubMed Central  Google Scholar 

  11. van de Wal HJ, Hamilton DI, Godman MJ, Harinck E, Lacquet LK, van Oort A (1992) Pulmonary venous obstruction following correction for total anomalous pulmonary venous drainage: a challenge. Eur J Cardiothorac Surg 6:545–549

    Article  PubMed  Google Scholar 

  12. Lahiri S, Wang Y, Caldarone CA, Morris SA (2020) Trends in infant mortality after TAPVR repair over 18 years in Texas and impact of hospital surgical volume. Pediatr Cardiol 41:77–87

    Article  PubMed  Google Scholar 

  13. Harada T, Nakano T, Oda S, Kado H (2019) Surgical results of total anomalous pulmonary venous connection repair in 256 patients. Interact Cardiovasc Thorac Surg 28:421–426

    Article  PubMed  Google Scholar 

  14. Hörer J, Neuray C, Vogt M et al (2013) What to expect after repair of total anomalous pulmonary venous connection: data from 193 patients and 2902 patient years. Eur J Cardiothorac Surg 44:800–807

    Article  PubMed  Google Scholar 

  15. Wilson WR Jr, Ilbawi MN, DeLeon SY et al (1992) Technical modifications for improved results in total anomalous pulmonary venous drainage. J Thorac Cardiovasc Surg. 103:861–870

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge the role of all our colleagues, perfusionists, nurses and others involved in the care of these babies.

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Qifeng Zhao.

Ethics declarations

Conflict of interest

All authors have completed the ICMJE uniform disclosure form. The authors have no conflicts of interest to declare.

Ethical statement

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by institutional ethics committee of the Second Affiliated Hospital and Yuying Children's Hospital and individual consent for this retrospective analysis was waived.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

**a, J., Ma, K., Ge, H. et al. Outcomes of Surgical Repair of Total Anomalous Pulmonary Venous Drainage: Role of Primary Sutureless Technique. Pediatr Cardiol 42, 1316–1323 (2021). https://doi.org/10.1007/s00246-021-02614-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-021-02614-0

Keywords

Navigation