TOTALLY ANOMALOUS PULMONARY VENOUS CONNECTION OUTCOMES FROM A SINGLE CENTER

M. Çi̇çek, O. Korun, Okan Yurdakök, H. F. Altın, M. A. Önalan, M. Bulut, Filiz Izgi Çoşkun, A. Şaşmazel, F. Özdemir, N. Aydemir
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Abstract

Objectives: There is limited data on totally anomalous pulmonary venous connection (TAPVC) repair results in our country. The aim of this study is to evaluate the early postoperative results of a large series of TAPVC patients operated in our clinic. Patients and Methods: The data of the patients who underwent TAPVC repair in our clinic between May 2005 and May 2021 were retrospectively reviewed using hospital records Results: A total of 150 TAPVC patients aged between 0 days and 39 years (median 3 months, IQR: 18 days – 9 months), 92 males (61%) and 58 females (39%) underwent surgical intervention. The median length of hospital stay was 12 (IQR:7-16) days. Overall mortality was 14% (21 patients). Seventeen out of 32 patients with additional cardiac anomalies (53%) and 4 out of 118 patients with isolated TAPVC (3%) died. The presence of additional cardiac anomalies was associated with mortality (p<0.00001). Mortality rate in univentricular patients was 59% (10 patients). This rate was higher in comparison to the mortality rate of biventricular patients (8%; p<0,00001). Three patients were reoperated due to postoperative pulmonary venous stenosis. Conclusion: The TAPVC outcomes in isolated and biventricular patients were favorable with a low mortality and postoperative pulmonary venous stenosis in this cohort. Patients with a single ventricle physiology and/or heterotaxia had a significantly increased risk of mortality, which might be due to the intrinsic challenges of the univentricular physiology regarding the balance between the pulmonary and systemic circulations. Tendency for increased mortality in the cases with preoperative pulmonary venous obstruction is a potential target for improvement.
单中心肺静脉连接完全异常
目的:在我国,关于完全异常肺静脉连接(TAPVC)修复效果的数据有限。本研究的目的是评估在我们诊所手术的大量TAPVC患者的早期术后结果。患者和方法:回顾性分析我院2005年5月至2021年5月间接受TAPVC修复的患者资料。结果:共有150例TAPVC患者,年龄在0天至39岁(中位3个月,IQR: 18天至9个月),其中男性92例(61%),女性58例(39%)接受手术干预。中位住院时间为12 (IQR:7-16)天。总死亡率为14%(21例)。32例附加心脏异常患者中有17例(53%)死亡,118例孤立性TAPVC患者中有4例(3%)死亡。其他心脏异常的存在与死亡率相关(p<0.00001)。单心室患者死亡率为59%(10例)。这一比率高于双心室患者的死亡率(8%;p < 0, 00001)。3例患者术后因肺静脉狭窄再次手术。结论:孤立性和双心室患者的TAPVC结果良好,死亡率低,术后肺静脉狭窄。单心室生理和/或异位性患者的死亡风险显著增加,这可能是由于单心室生理对肺循环和体循环平衡的内在挑战。术前肺静脉阻塞患者死亡率增高的趋势是改善的潜在目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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