Total Anomalous Pulmonary Venous Connection in Adults: Should We Offer Surgery?

Area of Science:

• Cardiology
• Thoracic Surgery
• Congenital Heart Disease

Background:

• Adults with total anomalous pulmonary venous connection (TAPVC) present unique surgical challenges.
• Understanding long-term surgical outcomes and pulmonary artery (PA) pressure changes is crucial for this patient group.

Purpose of the Study:

• To evaluate surgical outcomes in adult patients diagnosed with TAPVC.
• To assess the regression of pulmonary artery pressures following surgical correction of TAPVC.

Main Methods:

• Retrospective review of 49 adult TAPVC patients' hospital records (2003-2022).
• Analysis of surgical outcomes, including PA pressures, tricuspid regurgitation, and mortality.
• Long-term follow-up data collection for assessing sustained outcomes.

Main Results:

• A significant decrease in mean systolic PA pressure by 47.9% post-surgery.
• Reduction in moderate or severe tricuspid regurgitation from 55.1% to 6.1%.
• No intraoperative or 30-day mortality; 93.1% of patients were asymptomatic at follow-up.

Conclusions:

• Surgical repair of adult TAPVC is a safe procedure with favorable outcomes.
• TAPVC repair leads to regression of pulmonary hypertension and improved functional quality of life.
• Adult TAPVC patients can achieve good long-term results and lead healthy lives, including successful pregnancies.