Assessing the recently noted surgical outcome of isolated total anomalous pulmonary venous connection repair: A single-secondary center experience
Assessing the recently noted surgical outcome of isolated total anomalous pulmonary venous connection repair: A single-secondary center experience
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DOI：
10.1111/jocs.14284
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发表时间：
2019-10-15
影响因子：
1.6
通讯作者：
Kim, Eun Sun
中科院分区：
文献类型：
--
作者：
Choi, Eun-Young;Lee, Chang-Ha;Kim, Eun Sun
完全性肺静脉异位引流（TAPVC）是一种罕见的紫绀型先天性心脏病。本研究旨在评价单个中心过去12年中单独TAPVC修复术的结局和受累患者的复发情况。方法回顾性分析2007年至2018年51例单纯TAPVC修补术患者的病历。结果中位手术年龄为19 d，中位体重为3.3 kg。13例（25.5%）患者接受了急诊手术，中位随访期为29.54 ± 36.77个月。在5例患者中观察到早期死亡，在1例患者中观察到晚期死亡。22例患者在术后3至6个月内观察到肺静脉狭窄，6例患者需要再次手术或经导管介入治疗。低出生体重、小左心房容积、手术时间长和术前心力衰竭被确定为死亡的危险因素。结论单纯性TAPVC可迅速导致新生儿期血流动力学不稳定，并与高死亡率相关。提高产前诊断率，稳定术前病情是提高手术效果的重要措施。
Background and Aim of the Study Total anomalous pulmonary venous connection (TAPVC) is a rare cyanotic congenital heart defect. This study aimed to evaluate the outcome of isolated TAPVC repairs and the prognoses of affected patients in the last 12 years at a single center. Methods We retrospectively analyzed the medical records of 51 patients who underwent isolated TAPVC repair from 2007 to 2018. Results The median age at operation was 19 days, and the median body weight was 3.3 kg. Thirteen (25.5%) patients had emergency operations, and the median follow-up period was 29.54 +/- 36.77 months. Early mortality was noted in five patients and late mortality was noted in one patient. Pulmonary vein stenosis was observed in 22 patients within 3 to 6 months after the operation, and six patients required reoperation or transcatheter interventions. Low birth weight, small left atrial volume, long operation time, and preoperative heart failure were identified as risk factors for mortality. Conclusions Isolated TAPVC can rapidly lead to hemodynamic instability during the neonatal period and is associated with high mortality rates. Increasing the prenatal diagnosis rate and stabilizing the patients' condition before the operation are considered important for improving the surgical outcome.