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1 . 2023

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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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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