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Modified transseptal repair for total anomalous pulmonary venous connection repair in all age groups
Afksendiyos Kalangos1, Sanjay Cherian, Cécile Tissot
1Department of Cardiovascular Surgery, Geneva University Hospitals & Medical Faculty, Geneva, Switzerland.
Insights
This study shows a modified transseptal approach is safe and effective for repairing late-presenting totally anomalous pulmonary venous connection in children, with excellent long-term outcomes and no stenosis.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
Background:
- Totally anomalous pulmonary venous connection (TAPVC) is a rare congenital heart defect.
- Limited data exist on surgical outcomes for late-presenting TAPVC in children.
Purpose of the Study:
- To evaluate the safety and efficacy of a modified transseptal approach for surgical repair of unobstructed, late-presenting TAPVC.
- To assess early and late outcomes, including mortality and pulmonary venous stenosis.
Main Methods:
- Retrospective review of 11 pediatric patients with unobstructed TAPVC repaired using a modified transseptal approach.
- Median age at repair was 6.5 months.
- Median follow-up duration was 8.7 years.
Main Results:
- No early or late deaths were recorded.
- No instances of pulmonary venous stenosis were observed post-operatively.
- The modified transseptal approach facilitated surgical access and avoided circulatory arrest.
Conclusions:
- The modified transseptal approach is a viable and effective surgical strategy for late-presenting TAPVC.
- This technique offers excellent long-term results, including freedom from mortality and pulmonary venous stenosis.
Abstract:
Little data are available in late-presenting children with unobstructed totally anomalous pulmonary venous connection. Eleven patients underwent repair at a median age of 6.5 months using a modified transseptal approach to improve access and avoid circulatory arrest. There were no early or late deaths, and none of the patients presented pulmonary venous stenosis at a median follow-up of 8.7 years.
