Assessing the recently noted surgical outcome of isolated total anomalous pulmonary venous connection repair: A single‐secondary center experience

Choi, Eun-Young; Lee, Chang Ha; Park, Su‐Jin; Jang, So-Ick; Kim, Eun Sun

doi:10.1111/jocs.14284

Cited by 3 publications

(7 citation statements)

References 27 publications

(85 reference statements)

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“…These techniques are associated with some inherent complications, such as the need for reintervention (due to occlusion of the stent or the recurrence of PVO) and the need for anticoagulation. Research has shown that the mortality rate is 38% at 1 year and that the reintervention rate is 58% at 1 year [ 2 , 5 , 19 ]. Moreover, not all patients could tolerate these palliative measures, and patients needed to undergo surgery to correct the anomalous pulmonary veins [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The outcomes of the surgical repair of a total anomalous pulmonary venous connection (TAPVC) have historically improved, with the mortality rates reported in the literature ranging from 10 to 20% [ 1 , 2 ] or even below 7% [ 3 , 4 ], while emergency surgery reported had mortality rates as high as 25% [ 1 , 2 ].some patients have a risk of progressive pulmonary hypertension (PH) due to pulmonary venous obstruction (PVO), and other patients present with increasing cyanosis, tachypnea, hepatomegaly, hypoxia, gasping, or poor feeding [ 5 ] due to a delayed diagnosis. All these patients have a risk of progressive PH, suffer from severe respiratory distress and metabolic acidosis and require immediate intubation and inotropic support; more importantly, an emergency operation is needed.…”

Section: Introductionmentioning

confidence: 99%

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Emergency surgery without stabilization prior to surgical repair for total anomalous pulmonary venous connection reduces duration of mechanical ventilation without reducing survival

Pan

et al. 2021

J Cardiothorac Surg

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Background To examine two different operation timing for treating patients with a total anomalous pulmonary venous connection (TAPVC) who need emergency surgery and to summarize the effects of the two operation strategies. Methods A retrospective review of 54 patients with TAPVC who underwent operations within 72 h of presentation between December 2010 and July 2019 at a single institution was conducted. All patients exhibited respiratory or hemodynamic instability that required mechanical ventilation and inotropic support. Forty-four patients received emergency operations between 24 to 72 h due to stabilization of the patient’s condition. Stable hemodynamics were achieved, and a stable internal milieu was maintained before the operation. These patients comprised the Stable group (SG). Rather than being subjected to efforts to obtain stable hemodynamics and maintain a stable internal milieu, ten patients received emergency operations immediately within 24 h of diagnosis or an emergency operation is performed immediately due to uncorrectable acidosis or progressive cardiovascular collapse. These patients comprised the Unstable group (UG). The hospital course, operative data, and outpatient records were reviewed. Results In SG group, there were 23 exhibited the supracardiac type, 15 exhibited the cardiac type, 4 exhibited the cardiac type, and 2 exhibited the mixed cardiac type,3 patients were premature, the rest was term infant, PDA was the most common comorbidities (28 patients), the next is severe tricuspid valve regurgitation (21 patients). In UG group, there were 3 exhibited the supracardiac type, 4 exhibited the cardiac type, 3 exhibited the cardiac type, and no patient exhibited the mixed cardiac type, only 1 patient was premature, the rest were term infant. PDA (6 patients) and severe tricuspid valve regurgitation (5 patients) were the top two comorbidities. The median weight, median age at surgery, mean cardiopulmonary bypass (CPB) duration and mean aortic cross-clamp (ACC) duration were not significantly different between the two groups. The median postoperation durations of ventilator support were 8.1 ± 4.6 (2–13) days in the SG group and 4.9 ± 2.1 (2–18) days in the UG group, resulting in a significant difference (p = 0.008), the Post-op days in ICU and Days of hospitalization were 8.64 ± 4.04 days and 19.9 ± 4.27 days in the SG group and 5.6 ± 2.01 days and 14.7 ± 1.75 days in the UG group (P = 0.026 and 0.002). There were 12 hospital mortalities (27.3%) in the SG group and 2 hospital mortalities (20%) in the UG group, resulting in no significant difference in mortality (p = 0.636). Postoperative complications, such as low cardiac output and arrhythmia, were not significantly different between the two groups. The survival rates in the UG and SG groups at 5 years were 87.5 and 89.9%, respectively. There was no difference in survival between the two groups at the latest follow-up (SG group 89.9% versus UG group 87.5%, p = 0.8115). Conclusion An emergency operation should be performed immediately without any delay, it can reduce duration of mechanical ventilation and Days of hospitalization without reducing mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Emergency surgery without stabilization prior to surgical repair for total anomalous pulmonary venous connection reduces duration of mechanical ventilation without reducing survival

Pan

et al. 2021

J Cardiothorac Surg

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“…Research has shown that the mortality rate is 38% at 1 year and that the reintervention rate is 58% at 1 year 2,5,19 . Moreover, not all patients could tolerate these palliative measures, and patients needed to undergo surgery to correct the anomalous pulmonary veins 5 .…”

Section: Discussionmentioning

confidence: 99%

“…The outcomes of the surgical repair of a total anomalous pulmonary venous connection (TAPVC) have historically improved, with the mortality rates reported in the literature ranging from 10-20% 1,2 or being below 7% 3,4 . In contrast, some patients have a risk of progressive pulmonary hypertension (PH) due to pulmonary venous obstruction (PVO), and other patients present with increasing cyanosis, tachypnea, hepatomegaly, hypoxia, gasping, or poor feeding 5 due to a delayed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…The mean aortic cross-clamp (ACC) duration was 68.2 ± 25.1 (36-135) minutes in the SEO group and 54.7 ± 21.5 (range, 27-93) minutes in the EO group (p = 0.123). The median duration of ventilator support was 8.1 ± 4.6 (2-13) days in the SEO group and 4.9 ± 2.1(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) days in the EO group (p = 0.008). Patient demographics are listed inTable 2.…”

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confidence: 97%

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Total Anomalous Pulmonary Venous Connection Requiring Emergency Surgery: What Comes First?

Pan

et al. 2021

Preprint

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BackgroundTo examine two different methods for treating patients with a total anomalous pulmonary venous connection (TAPVC) who need emergency surgery and to summarize the effects of the two strategies by retrospectively reviewing the data of 54 patients.MethodsA retrospective review of 54 patients with TAPVC who underwent emergency operations between December 2010 and July 2019 at a single institution was conducted. All patients exhibited respiratory and hemodynamic instability that required mechanical ventilation and inotropic support. Forty-four patients received emergency operations within 24 to 72 hours due to stabilization of the patient’s condition. Stable hemodynamics were achieved, and a constant milieu interne was maintained before the operation. These patients comprised the subemergency operation (SEO) group. Rather than being subjected to efforts to obtain stable hemodynamics and maintain a constant milieu interne, ten patients received emergency operations immediately within 24 hours of diagnosis or an emergency operation is performed immediately due to uncorrectable acidosis or progressive cardiovascular collapse. These patients comprised the emergency operation (EO) group. The hospital course, operative data, and outpatient records were reviewed.ResultsThe median weight, median age at surgery, mean cardiopulmonary bypass (CPB) duration and mean aortic cross-clamp (ACC) duration were not significantly different between the two groups. The median durations of ventilator support were 8.1±4.6 (2-13) days in the SEO group and 4.9±2.1 (2-18) days in the EO group, resulting in a significant difference (p=0.008). There were 12 operative mortalities (27.3%) in the SEO group and 2 operative mortalities (20%) in the EO group, resulting in no significant difference in mortality (p=0.636). Postoperative complications, such as low cardiac output and arrhythmia, were not significantly different between the two groups. The actuarial survival rates in the EO and SEO groups at 5 years were 87.5% and 89.9%, respectively. There was no difference in actuarial survival between the two groups at the latest follow-up (SEO group 89.9% versus EO group 87.5%, p=0.8115).ConclusionRather than making efforts to achieve stable hemodynamics and maintain a constant milieu interne, an emergency operation should be performed immediately, and some efforts to address metabolic acidosis do not reduce mortality.

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Venous Flow Variation Predicts Preoperative Pulmonary Venous Obstruction in Children with Total Anomalous Pulmonary Venous Connection

White

Faerber

Katcoff

et al. 2021

Journal of the American Society of Echocardiography

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Assessing the recently noted surgical outcome of isolated total anomalous pulmonary venous connection repair: A single‐secondary center experience

Cited by 3 publications

References 27 publications

Emergency surgery without stabilization prior to surgical repair for total anomalous pulmonary venous connection reduces duration of mechanical ventilation without reducing survival

Emergency surgery without stabilization prior to surgical repair for total anomalous pulmonary venous connection reduces duration of mechanical ventilation without reducing survival

Total Anomalous Pulmonary Venous Connection Requiring Emergency Surgery: What Comes First?

Venous Flow Variation Predicts Preoperative Pulmonary Venous Obstruction in Children with Total Anomalous Pulmonary Venous Connection

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