Surgical repair for simple total anomalous pulmonary venous connection in neonates / 中华胸心血管外科杂志
Chinese Journal of Thoracic and Cardiovascular Surgery
;
(12): 449-456, 2021.
Artigo
em Chinês
| WPRIM
| ID: wpr-912304
ABSTRACT
Objective:
This study aimed at analyzing risk factors associated with surgical outcomes of neonatal total anomalous pulmonary venous connection (TAPVC) in our center.Methods:
A total of 105 neonates who underwent surgical repair for TAPVC from January 1st, 2009 to January 1st, 2018 were retrospectively analyzed. The anatomical types of TAPVC included supracardiac 42(40%, 42/105), cardiac 21(20%, 21/105), infracardiac 36(34.3%, 36/105), and mixed 6(5.7%, 6/105). The Cox proportional hazards analysis was used to analyze the risk factors related to postoperative pulmonary venous obstruction (PVO) and mortality. Kaplan- Meier analysis was used to analyze the overall survival rates.Results:
Twenty-six patients (24.8%, 26/105) were diagnosed with preoperative PVO. The 30-day, 1 year, and 5 years survival rate was 92.4%, 86.7%, and 86.7% respectively. Postoperative PVO occurred in 17 patients (16.2%, 17/105). Preoperative acidosis, low surgical weight, prolonged duration of cardiopulmonary bypass time, increasing postoperative central venous pressure (CVP), and reoperation were risk factors associated with mortality. Preoperative acidosis ( P<0.001), prolonged duration of cardiopulmonary bypass time ( P<0.001), and increasing postoperative CVP ( P=0.005) were independent risk factors for mortality. Mixed TAPVC, preoperative acidosis, low surgical age, prolonged cardiopulmonary bypass time, postoperative pulmonary arterial hypertension were risk factors associated with postoperative PVO. Prolonged cardiopulmonary bypass time ( P=0.029), postoperative pulmonary arterial hypertension ( P<0.001), and mixed TAPVC ( P=0.017) were independent risk factors associated with postoperative PVO.Conclusion:
The surgical outcomes of neonatal TAPVC in our center were acceptable, with low mortality rate and incidence of PVO. However, neonates with preoperative acidosis, prolonged duration of cardiopulmonary bypass time, and increased postoperative CVP had a poor prognosis. Patients with mixed TAPVC were at increased risk for postoperative PVO.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Tipo de estudo:
Estudo prognóstico
/
Fatores de risco
Idioma:
Chinês
Revista:
Chinese Journal of Thoracic and Cardiovascular Surgery
Ano de publicação:
2021
Tipo de documento:
Artigo
Similares
MEDLINE
...
LILACS
LIS