Type IV Total Anomalous Pulmonary Venous Connection

Louis, James D. St.; Turk, Elizabeth; Jacobs, Jeffrey P.; O’Brien, James E.

doi:10.1177/2150135116682456

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…We did not find anatomical subtypes or preoperative PVO to be risk factors as other centers have [2,9]. In particular, the mixed TAPVD subgroup has been associated with a high mortality rate [10,11]. Our institution's recent publication on the mixed TAPVD subgroup demonstrated that good results (5.6% early mortality) can be achieved after repair in patients with biventricular physiology [6].…”

Section: Commentmentioning

confidence: 60%

Long-Term Outcomes of Total Anomalous Pulmonary Venous Drainage Repair in Neonates and Infants

Yong

Yaftian

Griffiths

et al. 2018

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 60%

Long-Term Outcomes of Total Anomalous Pulmonary Venous Drainage Repair in Neonates and Infants

Yong

Yaftian

Griffiths

et al. 2018

The Annals of Thoracic Surgery

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“… 6 The wide spectrum of anatomic variation seen with this lesion could lead to failure to identify the exact anatomy of the pulmonary veins and influence the surgical outcome; hence, accurate preoperative understanding of the anatomy of the anomalous pulmonary venous connections is important. Risk factors for surgical mortality in mixed TAPVC included age < 2 months, obstructive TAPVC, pulmonary hypertensive crises, Type III mixed TAPVC, single ventricle physiology, heterotaxy syndrome, and prolonged cardiopulmonary bypass time 1,6,10 . The in‐hospital mortality in this study was 14% as compared to 5.6%–32% in other published studies (Table 3).…”

Section: Discussionmentioning

confidence: 50%

“…The in‐hospital mortality in this study was 14% as compared to 5.6%–32% in other published studies (Table 3). 1,6–12 The most common postoperative complications seen were pulmonary hypertensive crisis (28.6%), sepsis (28.6%), and seizures (21.4%). Patients who survive correction of mixed TAPVC have good mid to long‐term clinical outcomes, which was also noted in this study.…”

Section: Discussionmentioning

confidence: 99%

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Mixed type total anomalous pulmonary venous connection: Early results and midterm outcomes of surgical correction

et al. 2021

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Background and Aim of the Study The morphological heterogeneity of anomalous pulmonary venous drainage in mixed type total anomalous pulmonary venous connection (TAPVC) has important implications in preoperative diagnosis and surgical repair resulting in high mortality in these patients. Methods A retrospective review of 14 patients with mixed type TAPVC undergoing biventricular repair between January 2012 and December 2019 was conducted. A descriptive analysis was done, highlighting the anatomic variation, diagnostic and surgical approach, and surgical outcomes in these patients. Results The most common anatomic pattern was “3 by 1” (79%) followed by “2 by 2” (21%). The correct diagnosis by transthoracic echocardiography was made in 10 (71%) of the 14 patients. In contrast, preoperative computed tomographic (CT) angiography was performed in 10 patients and correct diagnosis was obtained in 8 (80%) of them. Pulmonary venous obstruction was seen in one patient before surgery. The in‐hospital mortality was 14% (2/14). Four patients had pulmonary hypertensive crisis in the postoperative period. The average follow‐up was 54 ± 27 months (range: 17–98 months) after surgical repair, and all surviving patients were asymptomatic. There was no late death. No clinically apparent sequelae were seen in six patients in whom isolated left superior pulmonary vein drainage was left uncorrected. Conclusion An accurate diagnosis of anatomic pattern in mixed type TAPVC can be difficult to establish in all the patients before surgery. Detailed intraoperative assessment, individualized surgical approach, and aggressive perioperative management may reduce surgical mortality. Operative survivors have good midterm outcome.

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“…Among these 103 patients, there were 11 patients with type IV TAPVC. In this report, we describe the anatomy of the pulmonary veins based on a system suggested by Chowdhury et al [14], which was validated in a large series by St. Louis et al [15]. Type IV A was characterized by a separate anomalous connection of veins from each lung: “2 + 2” pattern.…”

Section: Methodsmentioning

confidence: 99%

Two-stage correction of type IV total anomalous pulmonary venous connection

Shim

Yang

Jun

2017

J Cardiothorac Surg

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BackgroundThe small size of the pulmonary veins in infants increases the risk of pulmonary vein obstruction (PVO) after surgical repair of type IV total anomalous pulmonary venous connection (TAPVC). Here, we described the outcomes of our strategy, which delayed total correction after initial partial correction.MethodsWe reviewed the data of patients who underwent total correction for type IV TAPVC. In total, 11 out of 103 patients with TAPVC had type IV TAPVC with biventricular physiology. Of these 11 patients, we retrospectively reviewed the data of 7 patients who underwent two-stage correction. Major pulmonary venous confluent chambers, with the exception of the left superior pulmonary vein (LSPV), were initially anastomosed to the left atrium (LA), followed by anastomosis between the LSPV and the LA auricle.ResultsThe median weight, age, and LSPV size were 4.3 kg (range, 3.5–5.4 kg), 40 days (range, 20–103 days), and 4.5 mm (range, 3.0–5.4 mm), respectively, during the first operation and 12.2 kg (range, 8.5–31.5 kg), 1,165 days (range, 280–3,250 days), and 9.8 mm (range, 8.0–12.3 mm), respectively, during the second operation. The median Qp/Qs was 1.61 (range, 1.22–1.65) and the median cardiothoracic ratio was 0.52 (range, 0.49–0.57) at second operation. The median interval between the operations was 1,094 days (range, 196–3,226 days). The median follow-up period was 22 month (range, 7–59 month). No mortality or major morbidities occurred after either operation. The median Vmax at the LSPV anastomosis site was 1.0 m/s (range, 0.8–1.3 m/s) on predischarge echocardiography. This patency was maintained at the last follow-up, showing an identical median Vmax of 1.0 m/s (range, 0.8–1.3 m/s). All 7 patients who underwent two-stage correction were in good condition, without any clinical symptoms of PVO.ConclusionsOur results suggest that leaving the isolated LSPV uncorrected during infancy and performing a second operation when the LSPV has grown adequately is a viable treatment option for patients with type IV TAPVC.

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Type IV Total Anomalous Pulmonary Venous Connection

Cited by 10 publications

References 12 publications

Long-Term Outcomes of Total Anomalous Pulmonary Venous Drainage Repair in Neonates and Infants

Long-Term Outcomes of Total Anomalous Pulmonary Venous Drainage Repair in Neonates and Infants

Mixed type total anomalous pulmonary venous connection: Early results and midterm outcomes of surgical correction

Two-stage correction of type IV total anomalous pulmonary venous connection

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