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find Keyword "完全性肺静脉异位引流" 18 results
  • Treatment strategies of vertical vein during correction for total anomalous pulmonary venous connection in newborns

    ObjectiveTo compare the effect of different treatment strategies of vertical vein on the postoperative efficacy of total anomalous pulmonary venous connection (TAPVC) in newborns.MethodsThe clinical data of 72 TAPVC newborns who underwent correction in our hospital from June 2008 to January 2018 were retrospectively analyzed. There were 59 males and 13 females, with an average age of 9.93±8.13 d. According to different vertical vein treatment strategies, the patients were divided into an unligated group (22 patients), a partially ligated group (23 patients) and a completely ligated group (27 patients). The mortality and incidence of common complications among the groups were compared.ResultsIn the completely ligated group, the aortic cross-clamp time was longer (P=0.001), intraoperative circulatory arrest cases were less (P=0.005), and the early velocity of pulmonary vein was faster (P=0.029), but there was no significant difference in the velocity of pulmonary vein for the last follow-up among three groups (P=0.393). There was no significant difference in other perioperative indicators among groups, including the early mortality, the incidence of pulmonary vein obstruction and the non-closure of vertical vein after surgery (P>0.05). The mean follow-up time was 4.47±2.63 years. The follow-up mortality was not significantly different among groups (P>0.05). The cardiac function (NYHA) of all the 64 survived patients was classⅠ-Ⅱ.ConclusionProper vertical vein treatment strategies may be conducive to a smooth transition after surgery, ensuring the success of surgeries.

    Release date:2020-06-29 08:13 Export PDF Favorites Scan
  • Analysis of risk factors for pulmonary vein obstruction after intracardiac total anomalous pulmonary venous connection repair

    Objective To analyze risk factors for pulmonary vein obstruction (PVO) after intracardiac total anomalous pulmonary venous connection (TAPVC) repair. Methods A retrospective analysis of clinical data of the patients with intracardiac TAPVC who underwent surgery at our center from April 2009 to April 2019 was conducted. Kaplan-Meier curves were used to assess the risk of postoperative PVO. Logistic regression analysis was used to identify relevant risk factor for postoperative PVO. ResultsWe finally included 169 patients. The median age at surgery was 89.0 (41.5, 195.0) days, and the median weight at surgery was 4.8 (3.8, 6.0) kg. The preoperative PVO rate was 18.3% (31/169). Post-repair PVO occurred in 8.9% (15/169) of the patients. The atresia of common pulmonary and subtype of coronary sinus/right atrium did not significantly affect the risk of PVO (P=0.053, P=0.330). Relevant risk factors included preoperative PVO (P<0.001) and the ratio of left ventricular end-systolic diameter to right ventricular diameter (P=0.025). ConclusionSurgical repair of intracardiac TAPVC has achieved satisfactory results in our center, but the long-term risk of obstruction should not be underestimated. An increased ratio of left ventricular end-systolic diameter to right ventricular diameter and preoperative PVO are associated with post-repair PVO.

    Release date:2024-11-27 02:45 Export PDF Favorites Scan
  • Chinese expert consensus on diagnosis and treatment of total anomalous pulmonary venous connection

    Total anomalous pulmonary venous connection (TAPVC) is a relatively rare but complex congenital heart disease characterized by the anomalous drainage of the pulmonary veins. Rather than connecting to the left atrium, the pulmonary veins drain either directly or indirectly into the systemic venous circulation or the right atrium via abnormal pathways. While there is broad consensus on the diagnostic criteria for TAPVC, significant debate persists regarding the optimal timing of surgical intervention, preferred surgical techniques, and postoperative management including re-intervention strategies. This article formulates a Chinese consensus based on evidence-based data from the literature and opinions from domestic experts, with the goal of further standardizing the surgical treatment of TAPVC in China.

    Release date:2024-09-20 01:01 Export PDF Favorites Scan
  • Surgical treatment of infracardiac total anomalous pulmonary venous connection: A retrospective cohort study

    ObjectiveTo compare the outcomes of sutureless technique and conventional technique in the surgical repair for infracardiac total anomalous pulmonary venous connection (TAPVC).MethodsThe clinical data of 46 consecutive patients with infracardiac TAPVC undergoing surgical repair in our hospital between June 2014 and April 2019 were retrospectively analyzed. Patients with combined congenital cardiac anomalies such as single ventricle and tetralogy of Fallot were excluded. Patients were divided into a conventional technique group and a sutureless technique group according to the surgical techniques. There were 35 patients in the conventional technique group, including 28 males (80.0%) and 7 females (20.0%) with a median age of 21 (8, 42) d and a median weight of 3.6 (3.0, 4.0) kg. There were 11 patients in the sutureless technique group, including 8 males (72.7%) and 3 females (27.3%) with a median age of 14 (6, 22) d and a median weight of 3.5 (2.9, 3.6) kg. The curative effect of the two groups was compared.ResultsThere were 5 deaths (10.9%) in the conventional technique group, including 4 in-hospital deaths (8.7%) and 1 late death (2.2%). Overall mortality of the conventional technique group (14.3%, 5/35) was higher than that of the sutureless technique group (0.0%, 0/11), although the difference was not statistically significant (P=0.317). Cox regression analysis showed that sex (P=0.042), age at repair (P=0.028), cardiopulmonary bypass time (P=0.007), aortic cross-clamping time (P=0.018) and duration of ventilation (P=0.042) were risk factors for postoperative mortality. The median follow-up was 18.00 (5.00, 37.75) months. Postoperative pulmonary venous obstruction occurred in 22 patients of the conventional technique group, which was significantly more than that of the sutureless technique group (P=0.000).ConclusionFor infracardiac TAPVC, sutureless technique can reduce the incidence of postoperative pulmonary venous obstruction compared with conventional technique.

    Release date:2020-05-28 10:21 Export PDF Favorites Scan
  • 心上联合径路治疗婴幼儿心上型完全性肺静脉异位引流 47 例

    目的总结婴幼儿心上型完全性肺静脉异位引流的早期诊断和应用心上联合径路手术治疗经验。方法2011 年 9 月至 2017 年 9 月,我院共完成 47 例婴幼儿心上型完全性肺静脉异位引流的手术治疗,其中男 34 例、女 13 例,年龄 3 d~1 岁,平均年龄(3.5±2.6)个月,平均体质量 2.7~8.0(4.9±1.2)kg。患者均由超声心动图确诊。所有患者均在全身麻醉中度低温体外循环下行矫治术,均采用左心房顶部切口,心上联合径路行手术治疗。结果全组手术顺利,术后死亡 2 例,围手术期死亡率 4.3%。随访 45 例,随访时间 6 个月~6 年,随访期均行心电图、心脏超声、胸部 X 线片检查。所有患儿心电图示窦性节律,心影较术前明显缩小,肺充血消失,心功能明显好转,吻合口血流速度正常。结论婴幼儿心上型完全性肺静脉异位引流病情危重,早期诊断、心上联合径路手术效果良好。手术成功的关键在于吻合口足够大,充分利用左心耳扩大吻合口,避免术后肺静脉回流梗阻。

    Release date:2019-03-01 05:23 Export PDF Favorites Scan
  • 心上路径矫治新生儿期完全性肺静脉异位引流

    目的总结新生儿期心上型完全性肺静脉异位引流(TAPVD)的手术治疗经验,推广心上法在TAPVD手术治疗中的应用。 方法回顾性分析2008年8月至2013年8月上海儿童医学中心收治新生儿期心上型梗阻型TAPVD患儿7例的临床资料,其中男5例、女2例,年龄8~28(18.3±7.7)d,体重3.1~4.5(3.57±0.47)kg。全部患儿在全身麻醉低温体外循环下行心上法矫治术。 结果7例患儿术后早期(1个月内)无死亡。随访3个月至4年,吻合口均保持通畅,无明显肺静脉回流梗阻,中期随访无心律失常及死亡发生。 结论心上法矫治新生儿期心上型TAPVD可获得较大吻合口,减少心房内操作,有效降低术后死亡率、心律失常及吻合口再狭窄率。

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Surgery for pulmonary venous stenosis after total anomalous pulmonary venous connection repair: Midterm results of 9 patients

    ObjectiveTo review our experience of reoperations for pulmonary venous stenosis (PVS) after total anomalous pulmonary venous connection (TAPVC) repair for the past decade in Fuwai Hospital.MethodsNine patients underwent reoperation for PVS between 2009 and 2019 in Fuwai Hospital, including 4 males and 5 females with an average age of 5.10±5.00 years. The patients were divided into a sutureless group (n=3) and a non-sutureless group (n=6). Clinical data were reviewed and analyzed.ResultsFor primary TAPVC type, 4 patients were supracardiac, 2 patients were cardiac, 1 patient was infracardiac, and 2 patients were mixed-type anomaly. The median cardiopulmonary bypass time was 95 (63, 208) min, aortic clamping time was 58 (30, 110) min, ICU stay was 24 (24, 2 136) h. Early hospital death occured in 1 (11.1%) patient. One (11.1%) patient with single ventricle physiology had hospital comorbidity, who underwent hemofitration therapy. The follow-up time was 11.9 (2.2, 18.0) months, during which 1 patient died of restenosis of pulmonary vein and another patient died of stroke. No statistically significant difference was found between the sutureless group and non-sutureless group in postoperative or follow-up results (P>0.05). ConclusionSurgery is effective for treatment of PVS after repair of TAPVC, yet with a realatively high morbidity and mortality. The advantage of sutureless repair over conventional repair for this particular group of patients is yet to be verified.

    Release date:2021-11-25 03:54 Export PDF Favorites Scan
  • Surgical treatment strategy and outcome of functional univentricular heart with total anomalous pulmonary vein drainage

    Objective To explore the surgical management method and outcome of functional univentricular heart with total anomalous pulmonary vein drainage (UVH-TAPVD). Methods We reviewed the surgical procedures and results for 44 UVH-TAPVD patients in our hospital between the year 2010 and 2016. There were 34 males and 10 females. The age of the patients was 312 (77-4 220) d when they accepted the first surgical treatment. Results There were 8 deaths in stage Ⅰ palliation, 1 death in stage Ⅱ palliation and 5 deaths during the follow-up. The overall survival rate was 68.2% (30/44). Glenn operation was undertaken in 34 patients with 5 deaths. Fontan operation was undertaken in 9 patients with 2 deaths. Conclusion Surgical strategies for UVH-TAPVD should be planned according to different anatomical and pathophysiological conditions in different patients. Staged palliations can reduce mortality and morbidity. But pulmonary venous obstruction and heterotaxy syndrome are still risk factors for these patients.

    Release date:2018-01-31 02:46 Export PDF Favorites Scan
  • Treatment of supracardiac total anomalous pulmonary venous connection in a single center

    ObjectiveTo analyze the surgical results of patients with supracardiac total anomalous pulmonary venous connection (TAPVC) in a single pediatric cardiac center.MethodsA retrospective study was conducted on 98 pediatric patients with supracardiac TAPVC receiving surgical repair from 2014 to 2019 in our center. There were 64 males and 34 females with a median surgical age of 3.0 (1.5, 7.0) months and a median weight of 5.0 (4.0, 6.0) kg. Twenty-three (23.5%) patients had preoperative pulmonary vein obstruction. Ninety-two (93.9%) patients received conventional surgical repair, while six (6.1%) patients were treated with the sutureless technique. The Cox regression model was used to analyze the data.ResultsThe median follow-up time was 26.50 (5.75, 44.25) months. There were 9 (9.2%) deaths. Lower weight at the time of repair (P=0.013) and prolonged cardiopulmonary bypass time (P=0.007) were associated with mortality. Postoperative pulmonary vein obstruction was observed in 8 (8.2%) patients. Associated risk factors for postoperative pulmonary vein obstruction included lower weight at the time of repair (P=0.042) and prolonged cardiopulmonary bypass time (P=0.002).ConclusionSurgical repair of supracardiac TAPVC has achieved satisfactory results in our center. Risk factors such as lower weight at the time of repair and prolonged cardiopulmonary bypass time are associated with a poor prognosis.

    Release date:2022-01-21 01:31 Export PDF Favorites Scan
  • Sutureless technique use in the surgery for total anomalous pulmonary venous connection in neonates

    Objective To analyze the sutureless technique use in the surgical repair for total anomalous pulmonary venous connection in neonates. Methods Between September 2002 and December 2015, 71 consecutive neonates with supracardiac or infracardiac type total anomalous pulmonary venous connection who underwent surgical repair in our institute were included in this study. There were 57 males and 14 females at median age of 8 (1, 29) d. And the median body weight was 3.3 (2.1, 4.7) kg. There were 45 patients (63.4%) with supracardiac, 26 patients (36.6%) with infracardiac. Patients were divided into two groups: a conventional technique group (29 patients) and a sutureless technique group (42 patients). To control for potential differences in the characteristics of patients between the sutureless technique group and the conventional technique group, the method of propensity-score matching was used. Results Basic characteristics of patients after propensity-score were not different.There were 11 operative deaths (15.5%), 7 late deaths (96.%), total 18 deaths (25.4%). The mortality was 58.6% (17/29) in the conventional technique group, 2.4% (1/42) in the sutureless technique group (P=0.000). Kaplan-Meier survival curve showed a difference in mortality between the two groups (P=0.005). The patients were followed up for 25.5 (1.0-13.0) months.Postoperative anastomotic or pulmonary vein stenosis occurred in 12 patients, 8 of them died at a higher mortality than that of the patients with smooth anastomosis [66.7% (8/12) vs. 16.9% (10/59), P=0.001]. Conclusion The patients who have postoperative anastomotic or pulmonary vein stenosis have higher mortality. Compared with conventional technique, sutureless technique can dramatically decrease the incidence of postoperative anastomotic or pulmonary vein stenosis and the mortality of surgical repair for total anomalous pulmonary venous connection in neonates.

    Release date:2017-09-04 11:20 Export PDF Favorites Scan
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