Makoto Ando, Yukihiro Takahashi, Toshio Kikuchi
Sakakibara Heart Institute.
Japan
Interactive Cardiovascular and Thoracic Surgery
Interact Cardiovasc Thorac Surg 2004; 3: 557-561
DOI: 10.1016/j.icvts.2004.06.004
Abstract
Pulmonary venous obstruction after repair of total anomalous pulmonary venous connection remains potential and understanding of its mechanisms is warranted. Morphology of the pulmonary vein was qualitatively analyzed in 48 consecutive patients undergoing repair of non-isomeric total anomalous pulmonary venous connection. Pulmonary venous drainage was supracardiac in 26, cardiac in 7, infracardiac in 13, and mixed in 2. Nine had dysmorphic pulmonary venous confluence or tributary veins (Group A). Four had excessive (>or=5) tributary veins with a hypoplastic confluence (Type 1 abnormality). In the other four cases, the vertical vein was atretic (Type 2 abnormality). In a case with cardiac type, pulmonary veins had stenosis at orifices (Type 3 abnormality). The rest (n=39; Group B) had normal pulmonary vein. Eight patients (7 in Group A and 1 in Group B) developed postoperative pulmonary venous obstruction. Overall actuarial survival was 90.0% after 2.3 months up to 10 years. Actuarial freedom from pulmonary venous obstruction was 79.5% after 5.0 months up to 10 years. It was 22.2% at 1 year among Group A compared with 96.7% at 10 years among Group B (P<0.001). Morphological analysis of the pulmonary vein best predicted the incidence of postoperative pulmonary venous obstruction.
Category
Segmental Pulmonary Venous Disease. Without a Focus on Pulmonary Hypertension
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
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