Pulmonary venous obstruction following correction for total anomalous pulmonary venous drainage: a challenge

Wal, H. J. C. M. Van De; Hamilton, David; Godman, M J; Harinck, E.; Lk, Lacquet; Oort, A. Van

doi:10.1016/1010-7940(92)90006-j

Cited by 42 publications

(23 citation statements)

References 7 publications

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“…Pulmonary vein restenosis after repair of TAPVC is a significant risk factor for mortality in previous study [1,[19][20][21]. In our series, there were eight patients with pulmonary vein restenosis after surgical correction.…”

Section: Discussionmentioning

confidence: 58%

Risk Factors of Total Anomalous Pulmonary Venous Connection Surgery

Wu¹,

Kan²,

Wu³

et al. 2016

Ped Health Res

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Section: Discussionmentioning

confidence: 58%

Risk Factors of Total Anomalous Pulmonary Venous Connection Surgery

Wu¹,

Kan²,

Wu³

et al. 2016

Ped Health Res

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“…The survival rate after repair of TAPVC has improved [1] and the reported early mortality is less than 10% in many centers [2,3]. However, reported incidences of PVO after repair are still about 5-10% [9,10]. Usually PVO is classified into that related to intimal hyperplasia of the pulmonary vein (intrinsic) and that related to surgical stricture (extrinsic) [11].…”

Section: Discussionmentioning

confidence: 99%

Total anomalous pulmonary venous connection with dysmorphic pulmonary vein: a risk for postoperative pulmonary venous obstruction

Ando

Takahashi

Kikuchi

2004

Interactive Cardiovascular and Thoracic Surgery

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Pulmonary venous obstruction after repair of total anomalous pulmonary venous connection remains potential and understanding of its mechanisms is warranted. Morphology of the pulmonary vein was qualitatively analyzed in 48 consecutive patients undergoing repair of non-isomeric total anomalous pulmonary venous connection. Pulmonary venous drainage was supracardiac in 26, cardiac in 7, infracardiac in 13, and mixed in 2. Nine had dysmorphic pulmonary venous confluence or tributary veins (Group A). Four had excessive (>or=5) tributary veins with a hypoplastic confluence (Type 1 abnormality). In the other four cases, the vertical vein was atretic (Type 2 abnormality). In a case with cardiac type, pulmonary veins had stenosis at orifices (Type 3 abnormality). The rest (n=39; Group B) had normal pulmonary vein. Eight patients (7 in Group A and 1 in Group B) developed postoperative pulmonary venous obstruction. Overall actuarial survival was 90.0% after 2.3 months up to 10 years. Actuarial freedom from pulmonary venous obstruction was 79.5% after 5.0 months up to 10 years. It was 22.2% at 1 year among Group A compared with 96.7% at 10 years among Group B (P<0.001). Morphological analysis of the pulmonary vein best predicted the incidence of postoperative pulmonary venous obstruction.

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“…It is frequently associated with postoperative pulmonary venous obstruction (PVO), with an incidence of 5% to 18%. [1][2][3][5][6][7][8][9] Postoperative PVO may be a consequence of an inadequate anastomosis between the left atrium and pulmonary venous confluence, inadequate postoperative growth of the surgical anastomosis, or a reaction of tissues to prosthetic material used. In some cases, the obstruction is proximal to the operative site.…”

Section: Clinical Perspective On P 2726mentioning

confidence: 99%

Total Anomalous Pulmonary Venous Connection

Seale

Uemura²,

Webber³

et al. 2010

Circulation

235

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on behalf of the British Congenital Cardiac AssociationBackground-Late mortality after repair of total anomalous pulmonary venous connection is frequently associated with pulmonary venous obstruction (PVO). We aimed to describe the morphological spectrum of total anomalous pulmonary venous connection and identify risk factors for death and postoperative PVO. Methods and Results-We conducted a retrospective, international, collaborative, population-based study involving all 19 pediatric cardiac centers in the United Kingdom, Ireland, and Sweden. All infants with total anomalous pulmonary venous connection born between 1998 and 2004 were identified. Cases with functionally univentricular circulations or atrial isomerism were excluded. All available data and imaging were reviewed. Of 422 live-born cases, 205 (48.6%) had supracardiac, 110 (26.1%) had infracardiac, 67 (15.9%) had cardiac, and 37 (8.8%) had mixed connections. There were 2 cases (0.5%) of common pulmonary vein atresia. Some patients had extremely hypoplastic veins or, rarely, discrete stenosis of the individual veins. Sixty (14.2%) had associated cardiac anomalies. Sixteen died before intervention. Three-year survival for surgically treated patients was 85.2% (95% confidence interval 81.3% to 88.4%). Risk factors for death in multivariable analysis comprised earlier age at surgery, hypoplastic/stenotic pulmonary veins, associated complex cardiac lesions, postoperative pulmonary hypertension, and postoperative PVO. Sixty (14.8%) of the 406 patients undergoing total anomalous pulmonary venous connection repair had postoperative PVO that required reintervention. Three-year survival after initial surgery for patients with postoperative PVO was 58.7% (95% confidence interval 46.2% to 69.2%). Risk factors for postoperative PVO comprised preoperative hypoplastic/stenotic pulmonary veins and absence of a common confluence. Key Words: follow-up studies Ⅲ pulmonary veins Ⅲ pulmonary vein stenosis Ⅲ heart defects, congenital T otal anomalous pulmonary venous connection (TAPVC) is a rare form of congenital heart disease in which all pulmonary veins connect to the systemic veins, right atrium, or coronary sinus. TAPVC can occur in conjunction with a wide variety of cardiac malformations, especially atrial isomerism. Before the advent of cardiac surgery, almost all of these children died in the first few months of life. With treatment, there has been continued improvement in the mortality and morbidity of isolated TAPVC. [1][2][3][4] This can be attributed to progress in surgical expertise and to developments in intensive care such as use of nitric oxide and extracorporeal membrane oxygenation, which have led to salvage of the sickest neonates. Conclusions-Preoperative Clinical Perspective on p 2726Nevertheless, there is an ongoing late mortality in patients with TAPVC. It is frequently associated with postoperative pulmonary venous obstruction (PVO), with an incidence of 5% to 18%. [1][2][3][5][6][7][8][9] Postoperative PVO may be a consequence of an inadequate ana...

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Pulmonary venous obstruction following correction for total anomalous pulmonary venous drainage: a challenge

Cited by 42 publications

References 7 publications

Risk Factors of Total Anomalous Pulmonary Venous Connection Surgery

Risk Factors of Total Anomalous Pulmonary Venous Connection Surgery

Total anomalous pulmonary venous connection with dysmorphic pulmonary vein: a risk for postoperative pulmonary venous obstruction

Total Anomalous Pulmonary Venous Connection

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