Total anomalous pulmonary venous connection: 16 years of surgical results in a single center

Abstract

Purpose: The aim of the study was to analyze the surgical outcome of patients with total anomalous pulmonary venous connection (TAPVC) who underwent cardiac surgery.Methods: A retrospective study was carried out. Patients with diagnosis of TAPVC undergoing cardiac surgery at the National Institute of Cardiology Ignacio Chávez, from January 1, 2003 and June 30, 2019 were included. Descriptive statistics were calculated, as well as a bivariate analysis of the variables associated with mortality.A logistic regression model was included to determine risk factors associated with the main outcome and survival was analyzed using the Kaplan-Meier method.Results: A total of 5314 patients diagnosed with congenital heart disease (CHD) underwent surgery, 414 (7.8%) were patients with TAPVC, with an average age of 17.1 ± 34.6 months, 58.2% were male. It was frequent in infants (61.6%) and preschool (19.6%). Predominant type was supracardiac TAPVC (47.4%

Invited commentary: Total anomalous pulmonary venous connection remains a challenging pediatric disease

“…Complex congenital heart defects, such as TAPVC combined with single ventricle physiology, requires innovation and dedication for successful therapy and treatment 7 . The promising result of the study reported by Cervantes‐Salazar et al 1 gives our field hope for a better future for these patients.…”

“…Cervantes-Salazar et al 1 report the long-term surgical outcomes of 414 patients with total anomalous pulmonary venous connection (TAPVC) who underwent cardiac surgery at one institution from TAPVC comprises 1.5% of congenital heart disease, and necessitates emergent surgical repair in the neonatal or infantile period, immediately after confirmation with echocardiography. 2 Mortality is virtually 100% for those having PVO and being left surgically untreated by 4 months of age.…”

“…3 Therefore, the expectation for TAPVC repair, given today's advancements and technology, is before 4 months of age. Cervantes-Salazar et al 1 are to be commended for their experience with a high congenital case volume of 5000 patients between 2003 and 2019. TAPVC repair consisted of 7.9% of their cases, which is unusual compared to most literature.…”

“…Cervantes‐Salazar et al 1 report the long‐term surgical outcomes of 414 patients with total anomalous pulmonary venous connection (TAPVC) who underwent cardiac surgery at one institution from January 1, 2003 to June 30, 2019. The majority of patients were male infants with a median age of 5 months and having supracardiac TAPVC.…”

Therapy of Patients with Cardiac Malposition

“…Neonates with the total anomalous pulmonary venous return (TAPVR) with an obstruction to the pulmonary venous return should have immediate surgical correction [ 26 , 27 , 28 , 29 ]. It should be noted that some newborn infants with markedly reduced pulmonary blood flow may manifest TAPVR only after performing BT shunting.…”