Key result
In situ TAPVR repair without circulatory arrest shows ~7% early mortality and postoperative obstruction.
Why the study?
Surgical repair of TAPVR remains associated with high mortality and reoperation risk despite recent improvements in techniques and care.
Observational (n=29)
No
In situ surgical repair of TAPVR without total circulatory arrest in newborns and infants is associated with encouraging mid-term outcomes, though preoperative ventilator care and preoperative PVO increase mortality risk.
Preoperative ventilator care and PVO flag higher-risk TAPVR infants for intensified monitoring; observational data leaves open need for prospective validation.
Background: Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair.However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation.We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes.Methods: We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015.All patients were newborns or infants who underwent in situ TAPVR repair without TCA.Results: Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%).The median follow-up period for all patients was 42.9 months.Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO).Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality.Conclusion: In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes.Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair. Key words: 1. Congenital heart disease (CHD)2. Total anomalous pulmonary venous return 3. Total circulatory arrest
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Lee et al. (2016) conducted an observational in Total anomalous pulmonary venous return (n=29). In situ surgical repair without total circulatory arrest was evaluated on Early mortality. In situ surgical repair of total anomalous pulmonary venous return without total circulatory arrest resulted in an early mortality rate of 6.9% and a postoperative pulmonary venous obstruction rate of 6.9%.
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