Incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection

Ersin Erek, Dilek Suzan, Selim Aydın, Ramal Hesenov, Bahar Temur, Barış Kırat, Okan Yıldız, İbrahim Halil Demir, Ender Ödemiş

Acibadem Mehmet Ali Aydinlar University School of Medicine. Acibadem Atakent Hospital. Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital.
Turkey

Turkish Journal of Thoracic and Cardiovascular Surgery
Turk J Thorac Cardiovasc Surg 2019; 27: 471-477
DOI: 10.5606/tgkdc.dergisi.2019.17303

Abstract
Background: In this study, we aimed to investigate the incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection.
Methods: Between December 2010 and December 2016, a total of 40 patients (25 males, 15 females; mean age 45±41 days; range, 2 days to 6 months) who underwent total anomalous pulmonary venous connection repair were retrospectively analyzed.
Results: Eighteen (45%) of the patients were supracardiac, seven (17.5%) were cardiac, eight (20%) were infracardiac, and seven (17.5%) were mixed-type anomaly. Twelve patients (30%) had obstruction of the pulmonary venous pathways. Hospital mortality was seen in three patients (7.5%). All of non-survivors received emergent surgery and the causes of death were sepsis and multiple organ failure. A total of 23 complications were seen in 20 patients (50%) mainly delayed sternal closure (n=11; 27.5%) and prolonged mechanical ventilation (n=6; 15%). The mean follow-up was 12.2±9.6 (range, 1 to 36) months in all patients, except one. Pulmonary vein stenosis developed in three patients (8.3%) after repair. All of them underwent sutureless repair.
Conclusion: Total anomalous pulmonary venous connection can be repaired with low mortality and morbidity rates and favorable mid-term outcomes. Close follow-up is necessary due to the risk of development of pulmonary vein stenosis. Sutureless repair may provide relief in such cases.

Category
Stenosis or Obstruction of Pulmonary Veins Following Surgical Repair of Anomalous Pulmonary Venous Connections
Incidence or Prevalence of Disease
Surgical Interventions for Pulmonary Venous Obstruction After the Onset of Disease

Year of Publication: 2019

Age Focus: Pediatric

Article Type: Retrospective Observational Cohort Studies (>10 patients)

Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: Yes