Total anomalous pulmonary venous drainage in infancy

Area of Science:

• Pediatric Cardiology
• Congenital Heart Surgery
• Thoracic Surgery

Background:

• Total anomalous pulmonary venous drainage (TAPVD) is a critical congenital heart defect.
• Surgical correction is essential for infant survival.
• Early surgical intervention outcomes require continuous evaluation.

Purpose of the Study:

• To evaluate the surgical outcomes for infants undergoing correction of TAPVD.
• To identify factors influencing survival rates in TAPVD repair.
• To analyze mortality trends in relation to TAPVD subtypes and management strategies.

Main Methods:

• Retrospective analysis of 39 infants undergoing TAPVD correction between 1971 and 1975.
• Classification of TAPVD by drainage type: supracardiac, intracardiac, infracardiac, and mixed.
• Data collection on patient demographics, operative details, and mortality outcomes.

Main Results:

• Overall hospital mortality was 36% (14 of 39 infants operated on under 1 month of age).
• No late deaths were recorded post-hospital discharge.
• Highest operative mortality observed in patients with direct superior vena cava or infradiaphragmatic drainage, the latter group experiencing pulmonary venous obstruction.

Conclusions:

• Early recognition, prompt referral, and aggressive diagnostic approaches improve TAPVD outcomes.
• Comprehensive surgical correction with attention to anastomosis and left atrial size is crucial.
• Intensive postoperative care, particularly fluid balance and pulmonary complication management, significantly impacts survival.