The experience of surgical treatment of total anomalous pulmonary venous connection
Children’s Heart Center, Department of Cardiovascular and Thoracic Surgery, the Second Affiliated Hospital & Yuying Children’s Hospital Affiliated to Wenzhou Medical University, Wenzhou, 325027
WU Ji,HUA Qingwang,LIN Zhiyong, et al. The experience of surgical treatment of total anomalous pulmonary venous connection[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(12): 922-.
Abstract：Objective: To sum up the experience of surgical treatment of total anomalous pulmonary venous connection (TAPVC), to improve the successful rate of operation. Methods: The information of 76 patients with TAPVC undergone surgical correction in the hospital from January 2000 to December 2014 was analyzed retrospectively. In all patients, there were 45 males and 31 females aged 5 days to 8 years old. The weight ranged from 2.7 to 26.0 kg. Echocardiography, chest X-ray and electrocardiogram were used to confirm the diagnosis. CT angiography and three-dimensional reconstructions before operation was undergone in 31 cases. Supracardiac, intracardiac, infracardiac and mixed TAPVC were 39, 26, 8, 3, respectively. They were undrerwent TAPVC correction and repair of atrial septal defect with the superficial hypothermic CPB, except 1 patient with deep hypothermic circulatory arrest. Sixty-three cases of elective surgery, 13 cases of emergency operation were performed. Results: All patients were weaned from CPB with the time of circulation 72.5±14.4 (range, 48 to 156) min, the time of aortic cross clamping 51.6±12.8 (range, 29 to 93) min. Eight patients died early after operation (the mortality rate, 10.5%), 68 cases were cured. Forty-six cases were followed up with duration from 3 months to 5 years. 1 case of infracardiac TAPVC was died after 6 months of discharge due to severe pneumonia. One patient with postoperative anastomotic stenosis involved reoperation, the others recovered well. Conclusion: Once TAPVC confirmed should be operated as early as possible. Surgical treatment of TAPVC may be safe and satisfactory result. Through the improvement of various surgical techniques, the key to successful operation lies on the smaller trauma and the unobstructed flow from pulmonary vein to left atrium.
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