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Thorac Cardiovasc Surg 2020; 68(01): 024-029
DOI: 10.1055/s-0039-1700882
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Midterm Outcomes of Surgical Repair of Partial Anomalous Pulmonary Venous Connection to SVC

Jie Hu
1   Department of Cardio-Thoracic Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China
,
Renjie Hu
1   Department of Cardio-Thoracic Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China
,
Haibo Zhang
1   Department of Cardio-Thoracic Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China
,
Lei Zhang
2   Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China
,
Wen Zhang
2   Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China
,
Dian Chen
2   Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China
,
Wei Dong
1   Department of Cardio-Thoracic Surgery, Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai, China
› Author Affiliations Funding Key Discipline Group Development Fund of Health and Family Planning Commission of Pudong New District Grant Number: (PWZxq2017-14) Science and Technology Development Fund of Pudong New District (Grant Number: PKJ2014-Y05) Interdisciplinary Program of Shanghai Jiao Tong University (Grant/Award Number: ZH2018QNB11).
Further Information

Publication History

18 July 2019

19 September 2019

Publication Date:
15 November 2019 (online)

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Abstract

Objectives We explore midterm results after surgical treatment of partial anomalous pulmonary venous connection (PAPVC) to superior vena cava (SVC) in our institution.

Methods From 2008 to 2017, 78 patients underwent surgical repair for PAPVC to SVC. Patients were divided into three groups based on surgical techniques: Single-patch repair (n = 20, group A), double-patch repair (n = 31, group B), and Warden repair (n = 27, group C). Their median age was 1.9 years (range: 3 months–13.8 years); median weight was 11.4 kg (range: 4.4–39.7 kg). Clinical, electrocardiographic and echocardiographic were available for all patients.

Results There were no early or late mortality. The mean follow-up duration was 1.8 ± 2.1 years (range: 0.6 months to 8 years). No pulmonary venous obstruction occurred and no residual left-to-right shunts sustained during the follow-up. Reoperation for SVC obstruction was required: 1 (5.3%) in group A, 1 (3.2%) in group B, and 2 (7.4%) in group C (p = 0.78). Four patients (3 in group B, 1 in group C, p = 0.7) presented transient rhythm disturbance at discharge and one patient in group B remains nonsinus rhythm during follow-up. Pacemaker was not required in all patients.

Conclusion PAPVC to SVC can be safely managed by multiple techniques. Careful manipulation nearby sinus node must be emphasized during double-patch repair to prevent injury of sinus node. Obstruction of postoperative SVC stenosis should be paid attention to after Warden procedure. For young patients, operation should not be performed that early, but until preschool age.

Keywords

cardiac - pediatric - pulmonary arteries/veins - surgery - complications
 

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