Predictors of In-Hospital Mortality in Isolated Total Anomalous Pulmonary Venous Connection

We assessed risk factors for early mortality in isolated total anomalous pulmonary venous connection over a modern era excluding emergent cases to eliminate the influence of associated factors on surgical outcome.  Methods: 70 patients with isolated total anomalous pulmonary venous connection who were repaired electively between January 2013 and February 2018 were included.

In-hospital mortality was encountered in 4 patients (5.7%). Upon univariate analysis, low age (P = .003) and weight (P = .001) at surgery, preoperative pulmonary venous obstruction (P = .010), preoperative low oxygen saturation (P = .031), long cardiopulmonary bypass (P = .001) and aortic cross clamp (P = .003) times, long duration of mechanical ventilation (P = .001), chest infection (P = 0.041), postoperative low CO syndrome (P < .001) and long postoperative inotropic support (P = .015) were significant predictors of in-hospital mortality. In multivariate analysis postoperative low cardiac output syndrome (OR: 1.060; 95% CI: 1.008-1.116) and prolonged postoperative mechanical ventilation (OR: 1.772; 95% CI: 1.141-2.751) were independent factors of in-hospital mortality.

Surgical repair of TAPVC is now performed with acceptable results. According to our study, postoperative low cardiac output syndrome and prolonged postoperative mechanical ventilation were the most significant predictors for early mortality.