| Surgical Results for Functional Univentricular Heart With Total Anomalous Pulmonary Venous Connection Over a 25-Year Experience. | |
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MedLine Citation:
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PMID: 22206962 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Surgical results for functional univentricular heart with total anomalous pulmonary venous connection (TAPVC) have been unsatisfactory to date. METHODS: During a 25-year period until December 2009, 207 TAPVC patients underwent surgical repair at our institute, including 56 with a univentricular heart. The 10-year survival rate was 51.1% with univentricular heart and 84.7% with biventricular heart (p < 0.0001; log-rank, 27.6). Surgical outcomes and risk factors for early and late death after TAPVC repair in univentricular hearts were retrospectively analyzed. RESULTS: Patients were aged 3.8 ± 4.3 years and weighed 12.3 ± 10.7 kg at operation. Preoperative diagnoses included heterotaxy syndrome in 55, asplenia in 48, preoperative pulmonary venous obstruction in 35, and pulmonary atresia in 20. TAPVC was classified as I in 22, II in 26, III in 5, and IV in 3. Concomitant procedures included Fontan procedure in 29, bidirectional Glenn procedure in 5, systemic-pulmonary shunt in 11, and pulmonary artery banding in 5. There were 17 hospital deaths and 11 late deaths. Fontan completion was undertaken in 31 (55.3%). Postoperative pulmonary venous obstruction was found in 15. Multivariate analysis identified TAPVC III and IV and pulmonary atresia as risk factors for hospital death. Univariate analysis identified postoperative pulmonary venous obstruction and concomitant systemic-pulmonary shunt as risk factors for hospital and late death. CONCLUSIONS: TAPVC III, IV, and pulmonary atresia are risk factors for early postoperative death. Intensive intervention, including perioperative management and operation, is required in these complex patients. |
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Authors:
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Yuki Nakayama; Takeshi Hiramatsu; Yusuke Iwata; Toru Okamura; Takeshi Konuma; Goki Matsumura; Kenji Suzuki; Kyoko Hobo; Toshio Nakanishi; Hiromi Kurosawa; Kenji Yamazaki |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-27 |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: - ISSN: 1552-6259 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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