Surgical risk factors in total anomalous pulmonary venous connection

Lincoln, Christopher; Rigby, Michael L.; Mercanti, Corrado; Al-Fagih, Mohammad; Joseph, Michael; Miller, Graham; Shinebourne, E A

doi:10.1016/0002-9149(88)90774-6

Cited by 54 publications

(17 citation statements)

References 10 publications

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“…It also is possible that the cumulative effect of many small differences between groups (ie, those that are not statistically significant) could have contributed some degree of bias. Interestingly, children presenting with mixed anatomic type were not at increased risk of death after repair and no identifiable predilection to the development of postoperative PVO, in contradistinction to previous reports by Kirshbom et al 15 and Delius and colleagues. 4 Potential reasons for the lower prevalence of postoperative PVO in patients with mixed connection type in our series could be related to a lower prevalence of infracardiac connection within the "mixed" phenotype, differences in surgical repair technique, or incorrect assignment of connection type.…”

Section: Influence Of Patient Characteristicscontrasting

confidence: 68%

“…Bogers and colleagues 14 similarly found decreased operative mortality with hypothermic (18°C to 22°C) continuous perfusion with cardioplegic arrest compared with DHCA. However, others, including Lincoln et al 15 and Kirshbom et al, 13 have not found the use of DHCA to be a risk factor for mortality despite a favorable era effect and a coincident change in perfusion strategy. We also found that use of specific drugs in the immediate postoperative period, including milrinone, epinephrine, and nitroprusside, increased over time.…”

Section: Influence Of Eramentioning

confidence: 98%

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Factors Associated With Mortality and Reoperation in 377 Children With Total Anomalous Pulmonary Venous Connection

et al. 2007

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Background-We sought to determine era-specific changes in the incidence of mortality and reoperation in children with total anomalous pulmonary venous connection. Methods and Results-We reviewed the records of 377 children presenting from 1946 to 2005 with total anomalous pulmonary venous connection. Multivariable parametric regression models determined the incidence and risk factors for death and reoperation after repair. Pulmonary venous connection was supracardiac in 44%, infracardiac in 26%, cardiac in 21%, and mixed in 9%. Pulmonary venous obstruction was present in 48% at presentation, most frequently with infracardiac connection type (PϽ0.001). In total, 327 patients were repaired (median age, 1.7 months). Overall survival from repair was 65Ϯ6% at 14 years, with a current survival of 97%. Significant (PϽ0.01) incremental risk factors for postrepair death were cardiac connection type, earlier operation year, younger age at repair, use of epinephrine postoperatively, and postoperative pulmonary venous obstruction. More recent operation year was associated with younger age at repair (PϽ0.001), decreased use of deep hypothermic circulatory arrest (PϽ0.001), and use of specific drugs postoperatively (PϽ0.001). Risk-adjusted estimated 1-year survival for a patient repaired at birth with unfavorable morphology in 2005 is 37% (95% CI, 8 to 80) compared with 96% (95% CI, 91 to 99) for a patient with favorable morphology repaired at 1 year of age. Freedom from reoperation was 82Ϯ6% at 11 years after repair, with increased risk associated with mixed connection type (Pϭ0.04) and postoperative pulmonary venous obstruction (PϽ0.001). Conclusions-Mortality after total anomalous pulmonary venous connection repair has decreased but remains highest in young patients and in those with cardiac connection type or pulmonary venous obstruction. Unfavorable anatomic characteristics remain important determinants of postrepair survival despite improved perioperative care. (Circulation.

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Section: Influence Of Patient Characteristicscontrasting

confidence: 68%

Section: Influence Of Eramentioning

confidence: 98%

Factors Associated With Mortality and Reoperation in 377 Children With Total Anomalous Pulmonary Venous Connection

et al. 2007

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“…We put these risk factors to simple Cox regression analysis and noted a significant correlation (p=0.002, Table 3). In previous studies, low cardiac output syndrome was also reported as the main causes of early postoperative death [14,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Total Anomalous Pulmonary Venous Connection Surgery

Wu¹,

Kan²,

Wu³

et al. 2016

Ped Health Res

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“…Lincoln ve ark. [19]. yaptıkları çalışmada katetrizasyon işleminin özellik-le infantlarda genel durumun bozulmasına neden olarak, mortalite oranlarını arttırdığını göstermişlerdir.…”

Section: Discussionunclassified