Surgical Outcomes of Total Anomalous Pulmonary Venous Connection Repair: A 22-Year Experience

Padalino, Massimo A.; Cavalli, Giacomo; Franceschi, R N Marco De; Mancuso, Daniela Nardi; Maschietto, Nicola; Vida, Vladimiro L.; Milanesi, Ornella; Stellin, Giovanni

doi:10.1111/jocs.12399

Cited by 29 publications

(42 citation statements)

References 14 publications

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“…Over the last decade, surgical outcomes of TAPVC repair have improved with better control of pulmonary hypertension and preoperative clinical stabilization due to more aggressive medical management [6,9]. Our case presents an opportunity to consider an interventional strategy that palliates the disease to prevent an urgent need for definitive repair.…”

Section: Discussionmentioning

confidence: 91%

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Elective Stent Implant in the Obstructed Vertical Vein of Supracardiac Total Anomalous Pulmonary Venous Connection Prior to Operative Repair

Bratincsák¹,

Alstine²,

Koren³

et al. 2017

jshd

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Background: Total anomalous pulmonary venous connection (TAPVC) comprises 2% of congenital heart disease cases. Obstructed TAPVC typically presents with respiratory distress secondary to pulmonary congestion. We report a case of an infant patient who was electively referred to catheterization for stent placement to relieve vertical vein (VV) stenosis. Our objective was to prevent the emergent need for surgical intervention while allowing additional growth before surgery. Case Presentation: A 7-day-old, late pre-term, small for gestational age male infant was transferred from an outside institution. He was initially placed on nasal cannula due to oxygen saturation around 80% but progressed to continuous positive airway pressure and had a chest X-ray suggestive of pulmonary edema. Echocardiography revealed supracardiac TAPVC, a small apical muscular ventricular septal defect, and a moderate secundum atrial septal defect. On admission, the patient was clinically stable with a baseline oxygen saturation of 72% on 40% oxygen. Echocardiography confirmed supracardiac TAPVC and also showed an obstruction with a mean gradient of 22 mmHg in the VV. The desire to optimize the patient's clinical stability led to the decision to undergo cardiac catheterization for stent implantation in the VV. Immediately following the procedure, the patient's hemodynamics improved, with a pressure gradient between the pulmonary venous confluence and the left innominate vein of 4 mmHg. Conclusions: Over the last decade, surgical outcomes IntroductionTotal anomalous pulmonary venous connection (TAPVC) is a rare cardiac defect that comprises 2% of congenital heart disease cases [1]. TAPVC encompasses different anatomic subtypes in which pulmonary veins fail to connect directly to the left atrium and drain to the right atrium via an anomalous venous connection [2,3]. Supracardiac TAPVC is the most common type, comprising about 45% of cases [2]. A left-sided vertical vein (VV) accounts for 70% of the connections between the pulmonary confluence and the right atrium, and stenosis occurs in approximately 40% of cases [3].Obstructed TAPVC typically presents with respiratory distress secondary to pulmonary congestion,

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Section: Discussionmentioning

confidence: 91%

“…Low birth weight is an independent risk factor in the operative management of obstructive TAPVC [5,6,9]. Patients who undergo emergent VV stent implantation prior to definitive surgery often present with respiratory distress and cyanosis secondary to pulmonary congestion [4].…”

Section: Discussionmentioning

confidence: 99%

Elective Stent Implant in the Obstructed Vertical Vein of Supracardiac Total Anomalous Pulmonary Venous Connection Prior to Operative Repair

Bratincsák¹,

Alstine²,

Koren³

et al. 2017

jshd

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“…TAPVC has an excellent outcome if detected early and corrected surgically in due time, but the prognosis is poor when TAPVC is associated with a PVO [20] . The presence of PVO was significantly associated with an increased risk of death [3,8] .…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic evaluation of total anomalous pulmonary venous connection: comparison of obstructed and unobstructed type

Xiang

Zhang

Qiu

et al. 2019

Preprint

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Purpose The purpose of this study was to compare the differences between obstructed and unobstructed TAPVC using echocardiography, then to predict PVO by assessing clinical and echocardiographic parameters. Methods We conducted a retrospective study included 70 patients with TAPVC between 2014 and 2018. The morphological and hemodynamic echocardiographic parameters were observed and measured. The clinical and echocardiographic parameters that existed difference between obstructed and unobstructed TAPVC were selected to predict PVO by running ROC curve analysis. Results Between obstructed and unobstructed TAPVC, there were significant differences in ASD size, PA Vmax, MV VE, LVFS, LVEF, SV and the incidence of PDA, but there was no significant difference in birth weight. The first admission age of obstructed TAPVC was earlier than unobstructed type. The ROC curve analysis for the first admission age in predicting PVO showed the sensitivity and specificity were 76.7%, 80% respectively. The ROC curve analysis for multiple echocardiographic parameters showed the sensitivity and specificity were 82.6%, 100% respectively. Conclusions The presence of PVO led to anatomical and functional abnormity of patients with TAPVC, and then led to hospitalize earlier. The first admission age was a simple and feasible parameter in predicting PVO. The integrated use of multiple echocardiographic parameters had an excellent value in predicting PVO.

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“…Although surgical repair is the primary treatment modality for TAPVC patients, in critically ill patients, pulmonary vein obstruction or low body weight at the time of operation are potential risk factors for hospital mortality (3-6). The operative mortality is up to 7% for isolated TAPVC; this rate is higher in obstructed patients (5). Several previous cases have reported transcatheter interventional procedures as alternative therapeutic options for relief of obstruction and stabilizing clinical status before surgery (1, 3-4).…”

Section: Discussionmentioning

confidence: 99%

Life-saving urgent intervention in a low-birth-weight newborn with obstructed supracardiac total anomalous pulmonary venous connection: Stenting the vertical vein

Güzeltaş¹,

Öztürk²,

Kaşar³

2015

Anatol J Cardiol

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Surgical Outcomes of Total Anomalous Pulmonary Venous Connection Repair: A 22-Year Experience

Abstract: Surgical mortality and morbidity remain consistent in patients with TAPVC and associated major CHD, while the isolated type shows excellent outcomes. Pulmonary vein obstruction is a rare but highly lethal complication. doi: 10.1111/jocs.12399 (J Card Surg 2014;29:678-685).

Cited by 29 publications

References 14 publications

Elective Stent Implant in the Obstructed Vertical Vein of Supracardiac Total Anomalous Pulmonary Venous Connection Prior to Operative Repair

Elective Stent Implant in the Obstructed Vertical Vein of Supracardiac Total Anomalous Pulmonary Venous Connection Prior to Operative Repair

Echocardiographic evaluation of total anomalous pulmonary venous connection: comparison of obstructed and unobstructed type

Life-saving urgent intervention in a low-birth-weight newborn with obstructed supracardiac total anomalous pulmonary venous connection: Stenting the vertical vein

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