Total Anomalous Pulmonary Venous Connection: The Current Management Strategies in a Pediatric Cohort of 768 Patients
Authors' conclusion
Surgical correction in patients with TAPVC with a biventricular anatomy can achieve an acceptable outcome. Risk factors such as a younger age at the time of repair, infracardiac and mixed TAPVC, and preoperative PVO were associated with a poorer prognosis.
Study context
- Population
- Patients operated on for total anomalous pulmonary venous connection (TAPVC) at 2 congenital cardiac centres in Shanghai and Guangdong, China, 2005–2014
- Participants
- 768 patients
- Exposure
- Sutureless technique vs conventional repair
- Sutureless techniquen = 78
- Conventional repairn = 690reference
- Outcome
- Death and recurrent PVO
Methodological details2 congenital cardiac centres
- 2 congenital cardiac centres
Main finding
As reported in the abstract
Mortality
- Intraoperative deaths
- 38
- Late deaths
- 13
- Risk factor for mortality: younger age at repair
- P=0.001
- Risk factor for mortality: mixed TAPVC
- P=0.004
- Risk factor for mortality: infracardiac TAPVC
- P=0.035
- Risk factor for mortality: preoperative pulmonary venous obstruction (PVO)
- P=0.027
- Risk factor for mortality: prolonged cardiopulmonary bypass time
- P<0.001
- Risk factor for mortality: longer duration of ventilation
- P=0.028
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Restenosis in patients with preoperative PVO | P = 0.038 |
- Restenosis in patients with preoperative PVO: lower restenosis rate with sutureless; not in newborns (P=0.443)
Recurrent PVO among survivors · median follow-up 23.2 months (range 1-112)
- Recurrent PVO (of 717 survivors)
- 111 (15%)
- Risk factor: preoperative PVO
- P < 0.001
- Risk factor: infracardiac TAPVC
- P < 0.001
- Risk factor: mixed TAPVC
- P = 0.013
- Risk factor: prolonged cardiopulmonary bypass time
- P < 0.001
- Reintervention for restenosis
- 24
NYHA class I or II among survivors
- Survivors in NYHA class I or II
- 91%
Original publication
Total Anomalous Pulmonary Venous Connection: The Current Management Strategies in a Pediatric Cohort of 768 Patients. Circulation. Published 15 November 2016. doi:10.
Summarised from the published abstract; every number is checked against it