Modified closed chamber sutureless technique for anomalous pulmonary venous connection

Introduction: Total anomalous pulmonary venous connection (TAPVC) is a rare condition. Mortality of TAPVC has improved dramatically in the present. Sutureless closure had initially used for congenital pulmonary venous stenosis (PVS) or post-repair PVS. Recently, it had been adopted for primary TAPVC to prevent postoperative pulmonary venous obstruction, a leading cause of death. This technique had gradually applied at our institute for primary TAPVC since 2018. Methods: Prospective case series was conducted from mid-2019. Including criteria consists of patients with primary TAPVC. These are all supracardiac, infracardiac, mixed type and intracardiac TAPVC with pulmonary venous stenosis. Excluding measures are TAPVC with single ventricle, isomerism or heterotaxy. End-point outcomes were mortality and short-term PVS. Results: Seventeen TAPVC cases were enrolled in this study from 06/2019-12/2020 at Children's Hospital 1. Male/female ratio was 12/5. Median age at admission was 44 (3-1010) days old. The median operative weight was 3.9 kg (2.4-11). Of those, fourteen (82.4%) cases were supracardiac TAPVC and 3 (17.6%) cases were infracardiac TAPVC. Nine (52.9%) cases were emergency operations. Median aortic clamp time was 66 (32-138) mins. Median bypass time was 112 (86-212) mins. There were 9 (52.9%) cases with arrhythmias, 2 (11.8%) cases with chylothorax. Mean ventilation time was 3.6±0.5 days; mean CICU time was 6.5 (1-20), median LOS was 14.5 (8-39). In-hospital mortality was 5.9% (1). Mean follow-up time was 12.3±6.4 months (range 4-24), there was no PVS with median pulmonary venous score of 0 (range 0-1). Conclusions: Sutureless technique could be a safe option for primary TAPVC repair.

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Apex rotation as a risk factor for total anomalous pulmonary connection repair in single ventricle

10.22541/au.162127822.20134393/v1 ◽

2021 ◽

Author(s):

Hidetsugu Asai ◽

Yasushige Shingu ◽

Jin Ikarashi ◽

Yuchen Cao ◽

Daisuke Takeyoshi ◽

...

Keyword(s):

Risk Factor ◽

Vertebral Body ◽

Single Ventricle ◽

Right Atrial ◽

Pulmonary Venous Obstruction ◽

Sutureless Technique ◽

High Incidence ◽

Atrial Isomerism ◽

Anomalous Pulmonary Venous Connection

Background: The high incidence of postoperative pulmonary venous obstruction (PVO) is a major mortality-associated concern in patients with right atrial isomerism and extracardiac total anomalous pulmonary venous connection (TAPVC). We evaluated new anatomical risk factors for reducing the space behind the heart after TAPVC repair. Methods: 18 patients who underwent TAPVC repair between 2014 and 2020 were enrolled. Sutureless technique was used in 12 patients and conventional repair in six patients. The angle between the line perpendicular to the vertebral body and that from the vertebral body to the apex was defined as the “vertebral-apex angle (V-A angle).” The ratio of post- and preoperative angles, indicating the apex’s lateral rotation, was compared between patients with and without PVO. Results: The median (interquartile range) age and body weight at repair were 102 (79-176) days and 3.8 (2.6-4.8) kg, respectively. The 1-year survival rate was 83% (median follow-up, 29 [11-36] months). PVO occurred in seven patients (39%), who showed an obstruction of one or two branches in the apex side. The postoperative V-A angle (46° [45°-50°] vs. 36° [29°-38°], P = 0.001) and the ratio of post- and preoperative V-A angles (1.27 [1.24-1.42] vs. 1.03 [0.98-1.07], P = 0.001) were significantly higher in the PVO group than in the non-PVO group. The cut-off values of the postoperative V-A angle and ratio were 41° and 1.17, respectively. Conclusions: A postoperative rotation of the heart apex into the ipsilateral thorax was a risk factor for branch PVO after TAPVC repair.

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Sutureless technique versus conventional surgery in the primary treatment of total anomalous pulmonary venous connection: a systematic review and meta-analysis

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-018-0756-z ◽

2018 ◽

Vol 13 (1) ◽

Cited By ~ 4

Author(s):

Yuhao Wu ◽

Zhichao Wu ◽

Junmeng Zheng ◽

Yonggang Li ◽

Yuehang Zhou ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Primary Treatment ◽

Conventional Surgery ◽

Sutureless Technique ◽

Anomalous Pulmonary Venous Connection

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Primary Repair of Infracardiac Total Anomalous Pulmonary Venous Connection Using a Modified Sutureless Technique

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2008.01.093 ◽

2008 ◽

Vol 86 (1) ◽

pp. 320-322 ◽

Cited By ~ 18

Author(s):

Efren Buitrago ◽

Anthony L. Panos ◽

Marco Ricci

Keyword(s):

Primary Repair ◽

Sutureless Technique ◽

Anomalous Pulmonary Venous Connection

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Successful Repair of Coarctation of the Aorta and Obstructive Total Anomalous Pulmonary Veins Connection in a One-Day-Old Newborn

Medical University ◽

10.2478/medu-2020-0006 ◽

2020 ◽

Vol 3 (2) ◽

pp. 56-60

Author(s):

P.V. Teplov ◽

A.Yu. Miller ◽

A.M. Titov ◽

V.A. Sakovich

Keyword(s):

Cardiopulmonary Bypass ◽

Postoperative Period ◽

Clinical Case ◽

Pulmonary Veins ◽

Coarctation Of The Aorta ◽

Brain Perfusion ◽

Sutureless Technique ◽

Aortic Area ◽

Anomalous Pulmonary Venous Connection ◽

Successful Repair

AbstractA clinical case of successful repair of a combination of total anomalous pulmonary venous connection (TAPVC) with collector stenosis in one-day-old newborn. Only one case of successful correction of such a pathology is reported previously. The operation was performed with cardiopulmonary bypass and temporary antegrade brain perfusion. The narrowed aortic area was resected, the integrity of the aortic arch was restored using an extended anastomosis, and TAPVC correction was performed using a “sutureless technique”. The postoperative period was uneventful. The newborn was discharged from hospital on the 12th day.

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Supracardiac Total Anomalous Pulmonary Venous Connection

KYAMC Journal ◽

10.3329/kyamcj.v10i2.42792 ◽

2019 ◽

Vol 10 (2) ◽

pp. 118-121

Author(s):

ASM Shariful Islam ◽

Md Lutfar Rahman ◽

Jayanta Kumar Saha ◽

Mohammad Arifur Rahman ◽

Mezanur Rahman ◽

...

Keyword(s):

Left Atrium ◽

Ductus Arteriosus ◽

Pulmonary Veins ◽

Hypertensive Crisis ◽

Right Heart Failure ◽

Residual Shunt ◽

Low Cardiac Output Syndrome ◽

Vertical Vein ◽

Autologous Pericardial Patch ◽

Anomalous Pulmonary Venous Connection

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease in which there is developmental absence of connection of all four pulmonary veins with the left atrium. To report a rare case and share our experience in surgery and post-operative management for supracardiac TAPVC. Patient with supracardiac TAPVC with atrial septal defect (ASD) secundum variety with rudimentary patent ductus arteriosus (PDA) underwent rechanneling of pulmonary veins to left atrium (LA) with gluteryldehye treated autologous pericardial patch closure of ASD with ligation of ascending vertical vein and ligation of rudimentary PDA.Post operatively there were no events of pulmonary hypertensive crisis, low cardiac output syndrome, right heart failure or conduction defect were observed and echocardiogram showed adequate pulmonary venous drainage with no residual shunt across the interatrial septum. Marked development in surgical results of TAPVC has been observed in recent years with declining mortality rate from 65% in early sixties to 5% in current surgical scenerio. KYAMC Journal Vol. 10, No.-2, July 2019, Page 118-121

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