Risk Factors of Total Anomalous Pulmonary Venous Connection Surgery

Wu, Chung-Yu; Kan, Chung Dann; Wu, Jing‐Ming; Wang, Jieh Neng

doi:10.21767/2574-2817.100003

Cited by 3 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, both factors were associated with higher mortality but only low preoperative O2 saturation was statistically significant. This agrees partly with the study of Chi-Lun Wu and associates, where patients with preoperative low O2 saturation, especially those requiring preoperative mechanical ventilation or inotropic support, showed higher mortality [Wu 2016].…”

Section: Discussionsupporting

confidence: 92%

“…This was also true in our study with an incidence of 16% in our cases. PVO is linked in most studies, as well as ours, to both increased in-hospital mortality rate, and may be due to the need for emergent surgery, as well as increased incidence of postoperative pulmonary venous restenosis [Wu 2016;Karaci 2012;Husain 2012].…”

Section: Discussionmentioning

confidence: 59%

“…Therefore, in our cohort we included only cases with simple TAPVC over a recent period, minimizing the influence of associated anomalies as well as surgical eras on the early mortality. In addition, we excluded emergency cases which are associated with the highest mortality in most series due to combined factors like increased incidence of preoperative PVO and worsened symptoms of cyanosis (lower preoperative O2 saturation), as well as signs of heart failure which represent individual risk factors for early mortality [Karamlou 2007;Kanter 2006;Wu 2016;Kelle 2010]. To our knowledge, our study is thus unique in highly isolating risk factors of early mortality in simple TAPVC in elective patients.…”

Section: Discussionmentioning

confidence: 99%

“…Younger age as well as lower body weight at initial repair were noted to be significant risks for mortality in some studies [Karamlou 2007;Kanter 2006;Karaci 2012]. On the other hand, other studies like the study of Chi-Lun Wu and associates showed younger age at repair not to be a risk factor for mortality [Wu 2016]. There is a trend in pediatric cardiac surgery in general and in TAPVC in particular towards early repair once the diagnosis has been confirmed.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, these factors were not shown as risk factors in the studies of Karamlou T and Wu CL. When assuming that all operations are done by the same experienced surgeons, long CPB and aortic cross clamp times are usually attributed to more complex procedures due to unfavorable anatomy especially if other anomalies are associated [Karamlou 2007;Wu 2016].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

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

Elamry

Alkady

Menaissy

et al. 2019

HSF

View full text Add to dashboard Cite

Background: We assessed risk factors for early mortality in isolated total anomalous pulmonary venous connection over a modern era excluding emergent cases to eliminate the influence of associated factors on surgical outcome. Methods: 70 patients with isolated total anomalous pulmonary venous connection who were repaired electively between January 2013 and February 2018 were included. Results: In-hospital mortality was encountered in 4 patients (5.7%). Upon univariate analysis, low age (P = .003) and weight (P = .001) at surgery, preoperative pulmonary venous obstruction (P = .010), preoperative low oxygen saturation (P = .031), long cardiopulmonary bypass (P = .001) and aortic cross clamp (P = .003) times, long duration of mechanical ventilation (P = .001), chest infection (P = 0.041), postoperative low CO syndrome (P < .001) and long postoperative inotropic support (P = .015) were significant predictors of in-hospital mortality. In multivariate analysis postoperative low cardiac output syndrome (OR: 1.060; 95% CI: 1.008-1.116) and prolonged postoperative mechanical ventilation (OR: 1.772; 95% CI: 1.141-2.751) were independent factors of in-hospital mortality. Conclusion: Surgical repair of TAPVC is now performed with acceptable results. According to our study, postoperative low cardiac output syndrome and prolonged postoperative mechanical ventilation were the most significant predictors for early mortality.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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

Elamry

Alkady

Menaissy

et al. 2019

HSF

View full text Add to dashboard Cite

show abstract

Perioperative Anesthetic Management for Surgical Repair of an Adult with Supracardiac Total Anomalous Pulmonary Venous Communication and Pulmonary Hypertension: A case report and Mini Review

Datt¹,

Wadhwa²,

Kumar³

et al. 2021

JACCR

View full text Add to dashboard Cite

The total anomalous pulmonary venous communication [TAPVC] is a rare cyanotic congenital cardiac defect accounting for 1.5-3% of the congenital heart disease, in which pulmonary venous [PV] blood drains directly into the right side of the heart or into the systemic veins. Neonates with obstructive TAPVC may present with cyanosis, metabolic acidosis, respiratory failure, and shock. A subset of patients with unobstructed TAPVC may remain symptoms free and attain adulthood, or present with pulmonary congestion, pulmonary arterial hypertension [PAH]. The anesthetic management of either obstructed TAPVC or unobstructed with PAH can be quite challenging. The described patient is a 23-year male who presented with self – limiting single episode of chest pain, palpitations and dyspnea, diagnosed as supracardiac unobstructed TAPVC with ostium secundum atrial septal defect [OS – ASD] and PAH, who underwent successful intracardiac repair under cardiopulmonary bypass [CPB]. The protocol for the cardiac surgery during the COVID-19 pandemic for perioperative considerations and triage recommendations was strictly followed to reduce the risk of exposure to patients and healthcare workers. The objective of this case report and review is to recognize the spectrum of various clinical presentations in TAPVC, and to describe the diagnosis and perioperative management of TAPVC. Key Words: Adult Supra cardiac TAPVC, unobstructed, PAH, cardiopulmonary bypass, corrective surgery, balanced general anesthesia

show abstract

Kết quả điều trị bệnh lý bất thường hồi lưu tĩnh mạch phổi toàn phần tắc nghẽn và các yếu tố liên quan tỷ lệ tử vong tại Bệnh viện Nhi Đồng 2

Trương Thị Phương,

Lê Minh,

Hoàng Quốc

et al. 2023

PNTJMP

View full text Add to dashboard Cite

- Đặt vấn đề: Bất thường hồi lưu tĩnh mạch phổi toàn phần (BTHLTMPTP) là bệnh tim bẩm sinh hiếm gặp, tần suất mắc bệnh chiếm khoảng 7 - 9/ 100.000 trẻ sống và là một trong năm bệnh tim bẩm sinh tím thường gặp, chiếm tỷ lệ khoảng 0,7% - 1,5% trong tất cả các tật tim bẩm sinh. Tỷ lệ nhóm tắc nghẽn trước phẫu thuật chiếm từ 25% - 50% trường hợp và là một trong các yếu tố nguy cơ tiên lượng tử vong trong và sau phẫu thuật. Phẫu thuật điều trị BTHLTMPTP tắc nghẽn là cấp cứu ngoại khoa tim mạch với tỷ lệ tử vong có thể lên đến 38,5%. Bệnh viện Nhi Đồng 2 là một trong những trung tâm can thiệp tim mạch nhi hàng đầu, phẫu thuật tật tim này từ 2010, tuy nhiên chưa có nhiều nghiên cứu về kết quả phẫu thuật ngắn hạn. - Mục Tiêu: Đánh giá kết quả điều trị bệnh lý BTHLTMPTP tắc nghẽn và các yếu tố liên quan tỷ lệ tử vong tại Bệnh viện Nhi Đồng 2. - Phương pháp nghiên cứu: Mô tả hàng loạt ca. Hồi cứu các trường hợp BTHLTMPTP tắc nghẽn được chẩn đoán và phẫu thuật tại Bệnh viện Nhi Đồng 2 từ tháng 1 năm 2012 đến tháng 6 năm 2021. - Kết quả: Chúng tôi thu thập được 58 trường hợp thỏa tiêu chuẩn nghiên cứu. Kết quả điều trị như sau: thời gian trung bình nằm viện là 40 ngày, thời gian trung bình nằm hồi sức là 9,6 ngày, thời gian trung bình tuần hoàn ngoài cơ thể là 115 phút, thời gian kẹp động mạch chủ là 41 phút. Tỷ lệ các biến chứng sau phẫu thuật bao gồm: tỷ lệ cơn cao áp phổi 24,1%; tỷ lệ hội chứng cung lượng tim thấp 20,7%; tỷ lệ rối loạn nhịp 52% trong đó nhịp nhanh nhĩ chiếm tỷ lệ nhiều nhất; tỷ lệ hẹp miệng nối 29,3%; tỷ lệ hẹp tĩnh mạch phổi 13,8%; tỷ lệ can thiệp lần hai 13,8%; tỷ lệ nhiễm trùng 60,3% trong đó viêm phổi thường gặp nhất; tỷ lệ tử vong chung là 27,6 %. Các yếu tố liên quan tỷ lệ tử vong bao gồm: hội chứng cung lượng tim thấp, cơn cao áp phổi hậu phẫu, tắc nghẽn tĩnh mạch phổi sau phẫu thuật, mức độ toan máu nặng trước phẫu thuật. - Kết luận: Bất thường hồi lưu tĩnh mạch phổi toàn phần tắc nghẽn là tật tim bẩm sinh nặng. Có nhiều yếu tố giúp tiên lượng được khả năng sống còn của bệnh nhi sau phẫu thuật. Abstract - Introduction: Total anomalous pulmonary venous return (TAPVR) is a rare congenital heart disease, the frequency of which is about 7 - 9/100,000 live births and is one of the five common cyanotic congenital heart diseases, accounting for about 0.7% - 1.5% of all congenital heart defects. The proportion of group with preoperative obstruction accounts for 25% - 50% of cases and is one of the risk factors for predicting mortality during and after surgery. Surgical treatment of obstructed TAPVR is a cardiovascular surgical emergency with a mortality rate of up to 38.5%. Children’s Hospital 2 is one of the leading pediatric cardiovascular intervention centers, performing surgery for this heart defect since 2010. However, there have been no studies evaluating outcomes and factors related to mortality after treatment. - Objectives: To evaluate the outcomes of obstructed total anomalous pulmonary venous return (TAPVR) and the associated factors related to mortality at Children’s Hospital 2. - Methods: A retrospective study was conducted on patients with obstructed TAPVR diagnosed and surgically treated at Children’s Hospital 2 from January 2012 to June 2021. - Results: We collected data from 58 cases meeting the criteria. The outcomes were as follows: the average hospital stay duration was 40 days, the average intensive care unit stay duration was 9.6 days, the average extracorporeal circulation time was 115 minutes and the duration of aortic cross-clamp time was 41 minutes. Postoperative complications included 24.1% pulmonary hypertension, 20.7% low cardiac output syndrome, 52% arrhythmias (the most common one was atrial tachycardia), 29.3% anastomotic stenosis, 13.8% pulmonary vein stenosis, 13.8% re-intervention rate, and 60.3% infection rate (the most common one was pneumonia). The overall mortality rate was 27.6%. Factors associated with mortality included low cardiac output syndrome, postoperative pulmonary hypertension, postoperative pulmonary vein stenosis, and severe preoperative acidosis. - Conclusion: Obstructed TAPVR is a severe congenital heart defect. There are many factors predicting the patient’s survival after surgery.

show abstract

Risk Factors of Total Anomalous Pulmonary Venous Connection Surgery

Cited by 3 publications

References 14 publications

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

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

Perioperative Anesthetic Management for Surgical Repair of an Adult with Supracardiac Total Anomalous Pulmonary Venous Communication and Pulmonary Hypertension: A case report and Mini Review

Kết quả điều trị bệnh lý bất thường hồi lưu tĩnh mạch phổi toàn phần tắc nghẽn và các yếu tố liên quan tỷ lệ tử vong tại Bệnh viện Nhi Đồng 2

Contact Info

Product

Resources

About