Document Detail


Surgical Repair of Pulmonary Venous Stenosis: A Word of Caution.
MedLine Citation:
PMID:  25149045     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary vein stenosis (PVS), both congenital and acquired, is challenging to treat surgically with uncertain long-term results. We reviewed an 11-year surgical experience in 52 children.
METHODS: From 2002 to 2012, 52 children age 0 days to 13 years (mean 1.9 years, median 11.7 months) weighing 2.2 to 32.5 kg (mean 9.3 kg, median 7.6 kg) had surgical relief of PVS. Based on clinical characteristics or complexity, 33 (63%) had a sutureless pericardial well repair and 19 (37%) had a more standard patch repair. There were no significant differences in clinical characteristics between the 2 techniques. Twenty children (38%) had prior anomalous pulmonary vein repair and 8 had primary pulmonary vein stenosis; 26 (50%) had other operations at the time of PVS relief.
RESULTS: There were 2 hospital deaths (10.5%) in the "standard" group and 5 (15.2%) in the sutureless group (p > 0.99). Despite postoperative evidence of PVS relief by echocardiogram or cardiac cath in all patients, at 5 years, actuarial freedom from PVS recurrence or death in the hospital survivors was 67% in the standard group and 58% in the sutureless group. Most recurrences or deaths occurred within 6 months of operation. Heterotaxy, single ventricle anatomy, bilateral disease, and previous anomalous pulmonary vein repair were not predictors of failure.
CONCLUSIONS: Surgical treatment of pulmonary vein stenosis remains a challenging problem with nontrivial early mortality and ongoing risk for recurrence or death regardless of surgical technique employed. Clearly, development of methods for earlier intervention or detection and improved surgical techniques are warranted.
Authors:
Kirk R Kanter; Paul M Kirshbom; Brian E Kogon
Related Documents :
9203615 - Minimally invasive harvest of the saphenous vein for coronary artery bypass grafting.
4015385 - In situ distal saphenous vein bypass using the intraluminal valve-disruption technique.
1883185 - Location of valves and competence of the great saphenous vein above the knee.
17275245 - Technical modifications in endoscopic vein harvest techniques facilitate their use in l...
11759945 - Congenitally unguarded tricuspid valve orifice with a giant right atrium and a massive ...
3403445 - The lung at high altitude: bronchoalveolar lavage in acute mountain sickness and pulmon...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-19
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Endobronchial Ultrasonography for Positron Emission Tomography and Computed Tomography-Negative Lymp...
Next Document:  Brain magnetic resonance immediately before surgery in single ventricles and surgical postponement.