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Surgical treatment of mixed total anomalous pulmonary venous connection in infants / 中华实用儿科临床杂志
Chinese Journal of Applied Clinical Pediatrics ; (24): 753-756, 2021.
Article in Chinese | WPRIM | ID: wpr-882913
ABSTRACT

Objective:

To investigate the morphological characteristics and operative methods of mixed total anomalous pulmonary venous connection (TAPVC), and to analyze the risk factors of postoperative death.

Methods:

From January 2011 to January 2019, 17 cases of mixed TAPVC were operated in Department of Cardiovascular Surgery, Beijing Children′s Hospital, Capital Medical University, with 10 males and 7 females.The average age was (4.4±3.8) months (1-15 months) and the average body mass was (5.6±1.7) kg (3.5-10.0 kg), including 1 case of ventricular septal defect, 17 cases of atrial septal defect and 15 cases of ductus arteriosus.Preoperative pulmonary vein stenosis was discovered in 4 cases and severe pulmonary hypertension was in 10 cases.A total of 5 cases needed ventilator support before operation, and 2 cases needed emergency operation.The diagnosis was confirmed by color Doppler ultrasound and CT before operation.There were 2 cases of type Ⅰ (type 2+ 2), 13 cases of type Ⅱ (type 3+ 1), and 2 cases of type Ⅲ (anatomic variant).

Results:

All the patients were treated through operation.The principle of operation was to correct all pulmonary veins to the left atrium.The cardiopulmonary bypass time was (182.3±122.8) min, the aortic occlusion time was (84.3±15.9) min, the postoperative ventilator support time was (92.9±70.0) h, and the monitoring room time was (6.9±4.9) d. In this group, 3 cases died in hospital (17.6%) and 1 case died out of hospital (5.9%).

Conclusions:

The mortality of mixed TAPVC type Ⅲ was high, while preoperative pulmonary vein stenosis, severe pulmonary hypertension and the combination of sub-cardiac type were the important risk factors of death.The operation mode depends on the anatomic drainage mode, so individualized operation is recommended.
Full text: Available Index: WPRIM (Western Pacific) Type of study: Risk factors Language: Chinese Journal: Chinese Journal of Applied Clinical Pediatrics Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Risk factors Language: Chinese Journal: Chinese Journal of Applied Clinical Pediatrics Year: 2021 Type: Article