Repair of "simple" total anomalous pulmonary venous connection: a review from the Pediatric Cardiac Care Consortium.

Repair of "simple" total anomalous pulmonary venous connection: a review from the Pediatric Cardiac Care Consortium.
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DOI:
10.1016/j.athoracsur.2012.03.006
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发表时间:
2012-07
期刊:
The Annals of thoracic surgery
影响因子:
--
通讯作者:
Kochilas L
Kochilas L
中科院分区:
其他
文献类型:
--
作者:
St Louis JD;Harvey BA;Menk JS;Raghuveer G;O'Brien JE Jr;Bryant R 3rd;Kochilas L

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来自个别机构的完全性肺静脉异位连接(TAPVC)修复术的结果表明,在过去的几十年里,死亡率有了显著的改善。本研究的目的是从一个大型的多机构登记册中审查修复TAPVC后的结果。对多机构数据库的回顾,儿科心脏护理联盟(PCCC)被用来确定在1982至2007年间接受完全矫正的TAPVC诊断患者。回顾的数据包括年龄、初次手术十年、解剖类型、临床表现和住院死亡率。在提交给PCCC的118,084例手术中,2191例(1.9%)是TAPVC的初次手术矫正。队列中61%是男性,6.8%被报告为早产儿。单纯性TAPVC的住院手术死亡率为13%。1982年至1989年的死亡率为20%,1990年至1999年为16%,2000年至2007年为8%。肺静脉异位引流阻塞发生率为29%,病死率为26%。在过去的几十年里,先天性心脏畸形修复的手术结果有了显著的改善。需要多个机构的大型数据库来确认从单一机构经验中公布的结果。尽管在过去的三十年中,TAPVC的外科修复有了改善,但特定的亚型仍然有显著的死亡率。
Outcomes for repair of Total Anomalous Pulmonary Venous Connection (TAPVC) from individual institutions suggest a significant improvement in mortality over the last several decades. The purpose of this study is to review the outcomes following repair of TAPVC from a large multi-institutional registry. A retrospective review of the multi-institutional database, the Pediatric Cardiac Care Consortium (PCCC) was used to identify patients with the diagnosis of TAPVC who underwent complete correction between the years of 1982 to 2007. Data reviewed included age, decade of primary operation, anatomic type, presentation, and in-hospital mortality. Of the 118,084 surgical procedures submitted to the PCCC, 2191 (1.9%) were primary surgical correction of TAPVC. Sixty one percent of the cohort was male with 6.8% reported as premature. Overall in-hospital surgical mortality for simple TAPVC was 13%. Mortality was 20% from 1982 to 1989, 16% from 1990 to 1999, and 8% from 2000 to 2007. Obstruction to the anomalous pulmonary venous connection occurred in 29% with a mortality of 26%. Surgical outcomes from repair of congenital cardiac anomalies have significantly improved over the last several decades. Multi-institutional large databases are needed to confirm results published from single institutional experiences. Although improvements in surgical repair of TAPVC have occurred over the last three decades, specific subtypes still experience significant mortality.
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