Predictors of In-Hospital Mortality in Isolated Total Anomalous Pulmonary Venous Connection

Elamry, Eslam; Alkady, Hesham; Menaissy, Yasser; Abdalla, Osama

doi:10.1532/hsf.2415

Cited by 9 publications

(14 citation statements)

References 15 publications

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“…Moreover, in some patients, the hemodynamic status was still unstable after all of the measures mentioned above had been implemented, and an emergency operation became the only choice when the palliative techniques were abandoned, considering the aforementioned defects. Regarding the emergency operations themselves, the early mortality is similar to the result of other reports 1,3,24 .…”

Section: Discussionsupporting

confidence: 86%

“…Longer postoperative mechanical ventilation results in a higher risk of ventilatorassociated pneumonia and prolongs the length of stay. Additionally, studies have shown that prolonged postoperative mechanical ventilation is the most signi cant predictor of early mortality 24 . Long postoperative mechanical ventilation is usually attributed to the presence of chest infection or a worsened condition of heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the longer postoperative mechanical ventilation period in the SEO group might be explained as follows. First, an infusion of excess uid, aiming at stabilizing hemodynamics and correcting metabolic acidosis before the operation, has been demonstrated to worsen mechanical ventilation-related complications and aggravate pneumonia in critically ill patients 6,24 . Second, an infusion of excess uid and long-term application of cardiovascular drugs can also weaken myocardial functioning and prolong mechanical ventilation, as discussed above.…”

Section: Discussionmentioning

confidence: 99%

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Total Anomalous Pulmonary Venous Connection Requiring Emergency Surgery: What Comes First?

Pan

et al. 2021

Preprint

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BackgroundTo examine two different methods for treating patients with a total anomalous pulmonary venous connection (TAPVC) who need emergency surgery and to summarize the effects of the two strategies by retrospectively reviewing the data of 54 patients.MethodsA retrospective review of 54 patients with TAPVC who underwent emergency operations between December 2010 and July 2019 at a single institution was conducted. All patients exhibited respiratory and hemodynamic instability that required mechanical ventilation and inotropic support. Forty-four patients received emergency operations within 24 to 72 hours due to stabilization of the patient’s condition. Stable hemodynamics were achieved, and a constant milieu interne was maintained before the operation. These patients comprised the subemergency operation (SEO) group. Rather than being subjected to efforts to obtain stable hemodynamics and maintain a constant milieu interne, ten patients received emergency operations immediately within 24 hours of diagnosis or an emergency operation is performed immediately due to uncorrectable acidosis or progressive cardiovascular collapse. These patients comprised the emergency operation (EO) group. The hospital course, operative data, and outpatient records were reviewed.ResultsThe median weight, median age at surgery, mean cardiopulmonary bypass (CPB) duration and mean aortic cross-clamp (ACC) duration were not significantly different between the two groups. The median durations of ventilator support were 8.1±4.6 (2-13) days in the SEO group and 4.9±2.1 (2-18) days in the EO group, resulting in a significant difference (p=0.008). There were 12 operative mortalities (27.3%) in the SEO group and 2 operative mortalities (20%) in the EO group, resulting in no significant difference in mortality (p=0.636). Postoperative complications, such as low cardiac output and arrhythmia, were not significantly different between the two groups. The actuarial survival rates in the EO and SEO groups at 5 years were 87.5% and 89.9%, respectively. There was no difference in actuarial survival between the two groups at the latest follow-up (SEO group 89.9% versus EO group 87.5%, p=0.8115).ConclusionRather than making efforts to achieve stable hemodynamics and maintain a constant milieu interne, an emergency operation should be performed immediately, and some efforts to address metabolic acidosis do not reduce mortality.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Total Anomalous Pulmonary Venous Connection Requiring Emergency Surgery: What Comes First?

Pan

et al. 2021

Preprint

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“…The low incidence of postoperative low cardiac output syndrome in our cohort (4.90%) was consistent with the recent studies. 5 , 13 4 cases with low cardiac output syndrome may be involved in cardiomyoprotection during surgery or an excessive systemic inflammatory response in the first hours after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In resource-scarce conditions in clinical practice from Vietnam, the above characteristics in 2 dead cases drawn from the present cohort can enable to more solidly contribute to numerous previous evidence regarding the increased risk factors for early mortality. 5 , 13 , 16–18 …”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Early Postoperative Results of Total Anomalous Pulmonary Venous Connection Repair: Findings from Retrospective Single-Institution Data in Vietnam

Hung

Huy²,

et al. 2021

IBPC

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Introduction There are scanty reports of the risk factors for pulmonary hypertensive crisis and low cardiac output syndrome after the operative repair of total anomalous pulmonary venous connection (TAPVC). We aim to evaluate early surgical outcomes of TAPVC and risk factors for pulmonary hypertensive crisis and low cardiac output syndrome. Methods We conducted a retrospective medical record review for all patients undergoing operative repair of TAPVC within 5 years. Outcome variables included pulmonary hypertensive crisis, low cardiac output syndrome and early mortality. Results Of 58 patients, we documented 77.59% supracardiac, 20.69% cardiac and 1.72% mixed site of connection. About 86.21% patients underwent elective surgery, and 13.79% patients required emergency surgery. Incidence rates were 27.59% for pulmonary hypertensive crisis and 6.90% for low cardiac output syndrome. Body weight below 6 kg, pneumonia, tachycardia, hepatomegaly, preoperative pulmonary congestion on chest x-ray, preoperative elevated mean pulmonary artery pressure, preoperative pulmonary venous obstruction, emergency surgery and prolonged aortic cross-clamping time were significant risk factors for postoperative pulmonary hypertensive crisis. Significant risk factors for postoperative low cardiac output syndrome included pneumonia, prolonged duration of preoperative mechanical ventilation and prolonged aortic cross-clamping time. Conclusion The early outcome of surgical repair of TAPVC was acceptable, with 96.55% survival rate. This current analysis suggests that a thorough evaluation of all preoperative and operative characteristics is imperative to achieve best medical and surgical outcomes.

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Supracardiac total anomalous pulmonary venous connection type Ib: Morphology and outcomes

Liu

Liufu

Liu

et al. 2023

The Journal of Thoracic and Cardiovascular Surgery

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Predictors of In-Hospital Mortality in Isolated Total Anomalous Pulmonary Venous Connection

Cited by 9 publications

References 15 publications

Total Anomalous Pulmonary Venous Connection Requiring Emergency Surgery: What Comes First?

Total Anomalous Pulmonary Venous Connection Requiring Emergency Surgery: What Comes First?

Factors Associated with Early Postoperative Results of Total Anomalous Pulmonary Venous Connection Repair: Findings from Retrospective Single-Institution Data in Vietnam

Supracardiac total anomalous pulmonary venous connection type Ib: Morphology and outcomes

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