Conventional and sutureless techniques for surgical repair of supracardiac total anomalous pulmonary venous connection

Abstract

Objective To review our experiences with conventional and sutureless techniques in patients with supracardiac total anomalous pulmonary venous connection. Methods From January 2004 to January 2016, 150 patients with suparacardiac total anomalous pulmonary venous connection underwent conventional or sutureless techniques. Kaplan-Meier curve was used to demonstrate the survival estimates. Cox proportional hazard model was used to identify risk factors for death and postoperative pulmonary venous obstruction(PVO). Results There were 9 in-hospital deaths and 2 late deaths. The survival rates at 30 days, 1 year, and 12 years were 94.0%, 93.3%, and 92.7%, respectively. Follow-up was completed in 95.7% of the survivors. Median follow-up was 47 months(range: 0-136 months). Twenty-one patients required reoperation for pulmonary venous obstruction. The survival rates in neonate group is significantly lower than that in infants and children group(P=0.026). For those who were diagnosed with preoperative PVO, the survival rates(conventional group 92.3% VS sutureless group 93.9%, P=0.741) and incidence of freedom from reoperation(conventional group 55.6% VS sutureless group 90.9%, P=0.166) in both the conventional and sutureless group were similar. Multivariable analysis showed that preoperative pulmonary venous obstruction(P=0.015) and longer duration of ventilation(P=0.011) were incremental risk factors for death. Aortic cross-clamp time(P=0.038) was associated with postoperative pulmonary venous obstruction. Conclusion Both the conventional and sutureless techniques in surgical repair for supracardiac total anomalous pulmonary venous connection can achieve satisfactory outcomes. Key words: Total anomalous pulmonary venous connection; Surgical outcomes; Pulmonary venous obstruction; Sutureless technique