Primary Sutureless Repair of Total Anomalous Pulmonary Venous Connection: Suture-and-Open Technique

Kim, Hyungtae; Sung, Si Chan; Choi, Kyoo Wan; Lee, Hyoung Doo; Kim, Geena; Ko, Hoon

doi:10.1016/j.athoracsur.2018.05.026

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…In the study period, 49 patients underwent primary TAPVD repair. The anatomical type distribution was supracardiac in 51% (25), cardiac in 18% (9), infracardiac in 16% (8), and mixed in 14% (7) of the patients. Single ventricle lesions and heterotaxy syndromes were each present in 12% (6) of the patients.…”

Section: Resultsmentioning

confidence: 99%

“…The operative mortality of surgery varies widely in the literature between 4 and 35% [1][2][3][4]. Anatomical type [5], stenosis of the drainage pathway [6], surgical technique [6][7][8][9][10][11][12], and time era all are reported to have an important effect of short-and long-term outcomes. Associated single ventricle anomalies carry a particularly poor prognosis [13].…”

Section: Introductionmentioning

confidence: 99%

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Total anomalous pulmonary venous drainage repair: the effect of anatomical type and pulmonary vein stenosis on outcomes

et al. 2020

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Background: Surgical repair of total anomalous venous drainage (TAPVD) is lifesaving. The operative mortality is reported between 4 and 35%. Anatomical type, obstructed presentation, associated single ventricle, and heterotaxy syndromes are thought to influence short-and long-term outcomes. The effect of simple versus sutureless repair for primary surgery is unclear. This study reports the outcomes of the surgical repair and the effect of these variables in a contemporary setting. Results: Between 2011 and 2019, all patients undergoing surgical repair for TAPVD were included. Operative mortality, length of hospital stay, and long-term survival were reported. The effect of anatomical type, surgical technique, obstruction, and associated lesions was assessed. Pearson's test, Wilcoxson's test, and generalized linear regression with Poisson distribution were used. Forty-nine patients from two centers underwent TAPVD repair. The operative mortality was 4%. Postoperative pulmonary vein stenosis occurred in three patients, and reoperation was done in one patient. Survival free from reoperation was 98%, 98%, and 90% at 1, 24, and 60 months in the absence of pulmonary vein stenosis. However, all three patients who developed pulmonary vein stenosis died, at 0.5, 2.7, and 6.3 months of follow-up, respectively. We were unable to detect a significant effect of anatomical type, preoperative obstruction, associated single ventricle, or heterodoxy syndrome on operative mortality or long-term freedom from death or reoperation. Patients who presented with obstruction and infracardiac or supracardiac TAPVD had longer hospital stay. Conclusion: TAPVD repair outcomes are excellent except for patients who develop postoperative pulmonary venous stenosis. Anatomical type, obstructed presentation, associated single ventricle, or heterotaxy are not significant predictors of survival.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Total anomalous pulmonary venous drainage repair: the effect of anatomical type and pulmonary vein stenosis on outcomes

et al. 2020

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“…infracardiac TAPVC). However, in this case, the CPV was located lower right than usual, therefore, we performed transverse incision, 5 which enabled sutureless repair using both left and right atrial walls.…”

Section: Discussionmentioning

confidence: 97%

Primary sutureless repair concomitant with the Warden procedure

Watanabe

Nakata

Suehiro

et al. 2022

Asian Cardiovasc Thorac Ann

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A 2-month-old girl who had supracardiac total anomalous pulmonary venous connection (Darling classification type 1b) was referred to our institution. Computed tomography showed that multiple right upper pulmonary veins drained into the vertical vein, near the entry to the superior vena cava. The common pulmonary venous chamber was located lower right than usual, and right upper pulmonary veins were far from the common chamber. We successfully performed primary sutureless repair concomitant with the Warden procedure. Postoperative computed tomography showed unobstructed pulmonary veins and superior vena cava routes, and the vertical vein between right upper and lower pulmonary veins shrank slightly.

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“…5,6,9 At present, more and more studies suggest that for TAPVC patients who may be complicated by PVO after surgery, the initial orthopedic surgery may achieve better results by using the sutureless technique. [10][11][12] Sutureless surgery has obvious advantages as a primary correction of TAPVC: (1) this surgery can be applied to any type of TAPVC, and it is especially suitable for children with preoperative PVO 13 ; (2) The surgical field of pulmonary vein branches is better, thereby reducing the application of deep hypothermic circulatory arrest 14 ; (3) Avoiding direct anastomosis of the pulmonary vein endothelium, reducing local scarring and PVO caused by anastomotic distortion. 15 Conventional sutureless technology also has some drawbacks.…”

Section: Sutureless Proceduresmentioning

confidence: 99%

“…Wen et al 40 showed that preoperative pulmonary vein obstruction is a risk factor for postoperative pulmonary vein obstruction, which may be because it is difficult to form a large anastomosis between the small pulmonary vein and the left atrium, leading to the progression of postoperative pulmonary vein obstruction. In traditional surgical repair, pulmonary vein convergence and its branches are directly anastomosed with the left atrium, which may distort the pulmonary vein and damage the endothelial cells of pulmonary vein convergence, 10 resulting in a high incidence of postoperative PVO. Sutureless technology minimizes the contortion of pulmonary venous convergence and its branching veins to minimize the effect of flow turbulence.…”

Section: Risk Factors For Pvo and Death After Tapvcmentioning

confidence: 99%

Application of sutureless technique in total anomalous pulmonary venous connection repair

Wang

Ding

et al. 2022

Journal of Cardiac Surgery

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The sutureless technique was initially used for the treatment of postoperative pulmonary vein obstruction (PVO) in patients with total anomalous pulmonary venous connection (TAPVC). However, as the effectiveness of the sutureless technique has been confirmed and widely developed, the sutureless technique has been used for the primary treatment of high-risk children with TAPVC who are at high risk of PVO. Compared with traditional surgery, the sutureless technique significantly reduces the incidence of postoperative PVO, re-intervention rate due to PVO, and postoperative mortality, but there are potential complications such as pericardial and confluent venous anastomosis, phrenic nerve damage, air embolism.In addition, the sutureless technique is not effective in dealing with the progressive stenosis of the pulmonary veins after sutureless surgery and diffuse stenosis of extrapulmonary proximal veins and intrapulmonary veins. These make the efficacy and safety of this procedure controversial. This paper reviews the research status of the sutureless technique in TAPVC repair at home and abroad over the years.

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Primary Sutureless Repair of Total Anomalous Pulmonary Venous Connection: Suture-and-Open Technique

Cited by 5 publications

References 8 publications

Total anomalous pulmonary venous drainage repair: the effect of anatomical type and pulmonary vein stenosis on outcomes

Total anomalous pulmonary venous drainage repair: the effect of anatomical type and pulmonary vein stenosis on outcomes

Primary sutureless repair concomitant with the Warden procedure

Application of sutureless technique in total anomalous pulmonary venous connection repair

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