Total anomalous pulmonary venous connection beyond infancy
Kandakure Pramod Reddy1, Ramodass Nagarajan, Usha Rani
1Innova Children's Heart Hospital, Tarnaka, Hyderabad, India. drpramodreddy@yahoo.com
Insights
Surgical repair of total anomalous pulmonary venous connection in older children is safe and effective. This study shows acceptable outcomes for patients over infancy, with no early deaths or major complications.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Surgery
- Medical Technology
Background:
- Total anomalous pulmonary venous connection (TAPVC) is typically repaired in infancy.
- Delayed surgical correction beyond infancy presents unique challenges, particularly in developing nations.
- Limited data exists on outcomes for older pediatric TAPVC patients.
Purpose of the Study:
- To evaluate the safety and efficacy of surgical correction for TAPVC in children presenting beyond infancy.
- To assess postoperative outcomes, including morbidity and mortality, in this patient cohort.
- To analyze the impact of delayed repair on pulmonary artery pressure.
Main Methods:
- Retrospective review of 26 pediatric patients (age 1-16 years) undergoing TAPVC correction.
- Diagnostic confirmation using transthoracic echocardiography.
- Data collection on intensive care unit and hospital stay, postoperative complications, and follow-up outcomes.
Main Results:
- No early deaths or major postoperative complications were observed.
- Mean intensive care unit stay was 2.3 days and hospital stay was 9.2 days.
- Significant reduction in pulmonary artery pressure was noted post-surgery, with follow-up ranging from 10-40 months.
Conclusions:
- Surgical repair of TAPVC beyond infancy is a safe procedure with favorable outcomes.
- Delayed correction can lead to significant improvements in pulmonary artery pressure.
- This approach offers acceptable results for older pediatric TAPVC patients, even in resource-limited settings.
Abstract:
Most patients with total anomalous pulmonary venous connection are operated on in infancy, with low mortality and morbidity, but in developing countries, we still encounter patients beyond infancy. We describe our experience in 26 patients aged 1-16 years (mean, 5.01 years), with total anomalous pulmonary venous connection, who underwent correction between June 2007 and December 2009. Eleven patients were >5-years old. Transthoracic echocardiography was diagnostic in all cases. Mean intensive care unit stay was 2.3 ± 0.87 days, and hospital stay was 9.23 ± 2.34 days. There were no early deaths and no major postoperative complications. Follow-up ranged from 10-40 months. Pulmonary artery pressure, as judged by echocardiography, reduced significantly in all patients. Repair of total anomalous pulmonary venous connection beyond infancy can be carried out safely with acceptable results.
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