Results of isolated TAPVC surgery
Abstract
Background. Development of TAPVC surgery led to improvement of
surgical results and decrease in hospital mortality. There are a lot of risk factors,
affecting surgical results. In this study we present our result of surgery of
isolated TAPVC, analyzed through the prism of complex assessment of risk
factors during hospital period.
Material and methods.
164 patients with
isolated TAPVC and biventricular physiology, operated from 2001 to 2020, were
included in the study. The supracardiac type was in 76 (46.3%) patients,
cardiac type – in 46 (28.1%) patients, infracardiac type – in 32 (19.5%)
patients and mixed type – in 10 (6.1%) patients. Median weight of the patients
was 3.8 (3.3; 4.7) kg, age – 34 (14; 83) days of life, whereas age of 130
(79.3%) patients was less 3 months, 77 (46.9%) patients were newborns.
Preoperative pulmonary venous obstruction was detected in 71 (43.3%) cases.
Preoperative ICU was required in 86 (52.4%) cases, artificial pulmonary
ventilation – in 59 cases, inotropic support – in 33 cases. We analyzed the
impact of preoperative and intraoperative factors at early postoperative period
and surgical results, including risk factors of hospital mortality and their
cut-off values.
Results. The hospital mortality was 3.65 % (6/164). It was
shown that age, weight, preoperative PV obstruction, emergency, preoperative
pulmonary ventilation and inotropic support affected at early postoperative
period. The hospital mortality risk was increased by preoperative PV
obstruction (18.5 times) emergency (12.6 times), preoperative pulmonary
ventilation (25.6 times) and inotropic support (8.8 times). Moreover, duration
of the TAPVC surgery more than 195 min was defined as risk factor, increasing
hospital mortality risk (11.1 times). The complex analysis showed
disadvantageous combination of the risk factors that affected negatively
hospital mortality.
Conclusion. Surgical treatment of TAPVC can be performed with
hospital mortality less then 5%. Research of risk factors contribute to
improvement of surgical results and reduction of hospital mortality in TAPVC
patients.
Keywords:total anomalous pulmonary venous connection; hospital mortality; risk factors
Funding. The study had no sponsor support.
Conflict of interest.
The authors declare
no conflict of interest.
For citation: Morozov A.A., Movsesyan R.R., Boriskov M.V., Belov
V.A., Teplov P.V., Latypov A.K., Grekhov E.V., Tkachenko I.A., Miller A.Yu.,
Titov A.M., Didyk V.P. Results of isolated TAPVC surgery. Clinical and Experimental
Surgery. Petrovsky Journal. 2023; 11 (1): 86–91. DOI: https://doi.org/10.33029/2308-1198-2023-11-1-86-91
(in Russian)
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