The Outcomes of Total Anomalous Pulmonary Venous Connection in Neonates−10-Year Experience at a Single Center

Ji, Erchao; Qiu, Hailong; Liu, Xiaobing; Xie, Wen; Liufu, Rong; Liu, Tao; Chen, Jimei; Wen, Shusheng; Li, Xiaohua; Cen, Jianzheng; Zhuang, Jian

doi:10.3389/fcvm.2021.775578

Cited by 7 publications

(3 citation statements)

References 25 publications

(27 reference statements)

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“…In our study, the incidence of postoperative PVO is 2.5% which is low. Though previous studies showed mixed and infracardiac TAPVC are strongly associated with postoperative PVO ( 8 , 27 ). Our study showed no association between the types of TAPVC and risk of higher postoperative pulmonary vein flow velocity.…”

Section: Discussionmentioning

confidence: 90%

Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes

Meng

Zhang

et al. 2023

Front. Surg.

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IntroductionTotal anomalous pulmonary venous connection (TAPVC) is a rare but critical cardiac anomaly, in which pulmonary veins are connected to an abnormal location rather than the left atrium. The prognosis can be extremely poor without intervention, with a mortality of 80% during infancy. The purpose of this research is to summarize the outcomes and relevant risk factors of 80 total anomalous pulmonary venous connection (TAPVC) patients who underwent primary TAPVC sutureless repair and discuss the indications and benefits of primary sutureless repair.MethodsThis retrospective review included 80 patients with TAPVC who underwent primary sutureless repair at a single institution between January 2015 and December 2020. Patients were subdivided into 4 groups according to Darling's classification. Risk factors that increase the postoperative pulmonary vein flow velocity were explored by Multiple Linear regression.ResultsAnatomic TAPVC subtypes included supracardiac 35 (43.8%), cardiac 24 (30%), infracardiac 17 (21.2%), and mixed 4 (5%). Median age at repair was 16.5 days and median weight was 3.5 kg. Preoperative pulmonary venous obstruction (PVO)was presented in 20 (25%) patients. There were 2 early deaths and 1 late death. 2 patients developed postoperative PVO and none required reintervention. Prolonged cardiopulmonary bypass time (CPB) (p = 0.009), preoperative pneumonia (p = 0.022) and gender (p = 0.041) were found to be associated with the increase of postoperative pulmonary vein flow velocity.DiscussionUnder the primary sutureless technique, no statistical difference was observed among the 4 subgroups in terms of postoperative pulmonary vein flow velocity (p = 0.589). The primary sutureless technique may eliminate the differences between subtypes while decrease the postoperative PVO rate, which makes it applicable in any subtypes of TAPVC. Following the favorable outcomes in preventing postoperative PVO in all subtypes in this study, we advocate the indications for primary sutureless repair may expand further to all the TAPVC patients.

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Section: Discussionmentioning

confidence: 90%

Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes

Meng

Zhang

et al. 2023

Front. Surg.

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“…According to our inclusive criteria, we excluded several studies originating from the same institutions. Two studies ( 5 , 25 ) from The Hospital for Sick Children of Toronto, one study ( 26 ) from the Guangdong Cardiovascular Institute, and one multicenter study ( 1 ) were excluded to avoid overlapping of data. Although the multicenter study performed by Shi et al ( 1 ) had the largest TAPVC cohort, this study was excluded because it overlapped with the other two included studies ( 8 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

Sutureless Technique for Primary Total Anomalous Pulmonary Venous Connection Repair: An Updated Meta-Analysis

Zhao

Pan

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAn updated meta-analysis was performed to explore the clinical outcomes following the sutureless repair in patients with total anomalous pulmonary venous connection (TAPVC) and compare outcomes between the sutureless technique and conventional surgery.MethodsA systematic search of PubMed, Ovid-Embase, and Cochrane Library (CENTRAL) for relevant published studies that reported the clinical outcomes of the sutureless technique in children with TAPVC was performed in February 2022. The publication language was restricted to English.ResultsEleven studies were included involving 771 patients in total. Following the sutureless technique, the incidences of postoperative pulmonary venous obstruction (PVO) and reoperations due to PVO were 3.3% [95% confidence interval (CI), 1.3–5.3%] and 1.8% (95% CI, 0.3–3.3%), respectively. The early and late mortality rates were 3.2% (95% CI, 1.0–5.3%) and 2.5% (95% CI, 0.7–4.3%), respectively. Compared with conventional surgery, the sutureless technique significantly reduced the incidences of postoperative PVO [odds ratio (OR), 0.16; 95% CI, 0.08–0.33; P < 0.00001], reoperations due to PVO (OR, 0.25; 95% CI, 0.10–0.63; P = 0.003), and early mortality (OR, 0.40; 95% CI, 0.21–0.79; P = 0.008). However, no significant difference was found between conventional surgery and the sutureless technique concerning late mortality (OR, 0.63; 95% CI, 0.13–3.00; P = 0.58).ConclusionThe sutureless technique is superior to conventional surgery for the primary repair of TAPVC concerning postoperative PVO, reoperations due to PVO, and early mortality. However, the level of evidence is of low quality. Prospective cohort studies or randomized control trials (RCTs) should be performed to evaluate the effectiveness of sutureless techniques for primary TAPVC repair.

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“…Unsurprisingly, this result may reflect the greater complexity of the surgical manoeuvres or the poorer preoperative status in patients who required more time for bypass support, i.e. poor cardiac function, pulmonary hypertension owing to the preoperative pulmonary congestion and/or acidosis [ 25 ]. On the other hand, this risk factor can be potentially mitigated by the use of ST because a simpler oval suture line is required in the ST compared with the complex and irregular contour of the incision required in the standard repair.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative pulmonary venous obstruction after surgical repair of total anomalous pulmonary venous connection: a systemic review and meta-analysis

Zhang

Shi

Chen

2022

Interactive CardioVascular and Thoracic Surgery

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Background A meta-analysis was performed to investigate the risk factors of postoperative pulmonary venous obstruction (PVO) after surgical repair of total anomalous pulmonary venous connection (TAPVC). Methods Data bases including Pubmed, Embase, Web of Science and Cocrane Libarary were searched systematically for this study aiming to discuss the risk factors for post operation PVO of TAPVC. Publications were screened by two authors independently for criteria inclusion, methodological quality assessment, and data extraction. Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality (AHRQ) checklist were obtained to assess the quality of studies. Data were pooled by random effect model or fixed effect model according to the heterogeneity test. Results A total of 16 studies (2,385 participants) were included into a meta-analysis. All included studies were retrospective studies. Six potential risk factors were pooled, five of which were significantly associated with postoperative PVO. Patients with preoperative PVO were more likely to suffer from postoperative PVO [odds ratio (OR)=5.27, 95% CI = (2.75, 10.11), P < 0.01]. Comparing with sutureless procedure, conventional operation procedure was associated with postoperative PVO [OR = 1.80, 95% CI = (1.20, 2.71), P < 0.01]. Mixed type TAPVC plays a critical role in postoperative PVO [OR = 3.78, 95% CI = (1.08, 13.18), P = 0.04]. Inverse variance analysis showed that longer cardiopulmonary bypass (CPB) time [hazard ratio (HR)=1.01, 95% CI = (1.01, 1.02), P < 0.00001] and aortic cross-clamp (ACC) time [HR = 1.01, 95% CI = (1.01, 1.02), P < 0.01] were significantly associated with postoperative PVO. Whereas, heterotaxy [OR = 1.18, 95% CI = 0.13, 10.45, P = 0.88] was not statistically significant as a risk factor for postoperative PVO. Conclusions The meta-analysis we presented may provide a perspective on the risk factors of postoperative PVO of TAPVC, thus, furthering studies predicting postoperative PVO of TAPVC with our findings.

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The Outcomes of Total Anomalous Pulmonary Venous Connection in Neonates−10-Year Experience at a Single Center

Cited by 7 publications

References 25 publications

Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes

Total anomalous pulmonary venous connection in 80 patients: Primary sutureless repair and outcomes

Sutureless Technique for Primary Total Anomalous Pulmonary Venous Connection Repair: An Updated Meta-Analysis

Risk factors for postoperative pulmonary venous obstruction after surgical repair of total anomalous pulmonary venous connection: a systemic review and meta-analysis

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