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Surgical experience of total anomalous pulmonary venous connection with mid-term follow-up in a developing country
K Shivaprakash1, T R Swaminathan, G Rao Suresh
1Institute of Cardiovascular Diseases, Madras, India.
Insights
This study on total anomalous pulmonary venous connection (TAPVC) surgery found higher mortality rates in certain regions. Key surgical risk factors and the impact of sociodemographic elements on outcomes were identified.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Congenital Heart Disease Research
Background:
- Total anomalous pulmonary venous connection (TAPVC) is a critical congenital heart defect requiring surgical intervention.
- Outcomes for TAPVC surgery can vary significantly based on geographic location and patient-specific factors.
Purpose of the Study:
- To detail the incidence, age distribution, clinical variations, surgical risk factors, and follow-up outcomes of TAPVC in a specific global region.
- To identify factors contributing to higher surgical mortality in this population.
Main Methods:
- A retrospective analysis of hospitalized patients diagnosed with TAPVC.
- Data collected from institutional practice, including corrective surgery and follow-up ranging from 3 months to 5 years.
Main Results:
- Twenty hospital deaths occurred postoperatively, with a mean follow-up of 1.9 years.
- Logistic regression identified age, surgical timing, comorbidities, lesion type, pulmonary hypertension, ventilation duration, and low cardiac output as significant surgical risks.
- Mean survival time ranged from 4 to 8 years.
Conclusions:
- Higher mortality rates in this region are linked to severe malnutrition and delayed presentation.
- Sociodemographic factors significantly influence surgical outcomes in addition to identified clinical risk factors.
Objective:
To illustrate the incidence, the different age group, varied clinical presentation, incremental risk factors for surgery and follow-up results from this part of the world.
Experimental Design:
Retrospective study with follow-up from 3 months to 5 years.
Setting:
Institutional practice with hospitalised care.
Selection Procedure:
Hospitalised patients with a diagnosis of total anomalous pulmonary venous connection.
Interventions:
All patients who were diagnosed to have total anomalous pulmonary venous connection underwent corrective surgery.
Results:
There were 20 hospital deaths postoperatively. The mean follow-up was 1.9 year. Logistic regression analysis identified age group, timing of surgery, associated anomalies preoperative symptoms, anatomical type of lesion, pulmonary artery hypertension, duration of ventilation, low cardiac output as risk factors for surgery. The mean survival time was 4-8 years.
Conclusion:
Mortality continues to be higher from this part of the world due to severe malnourishment, late presentation. Sociodemographic factors also play a major role in affecting surgical outcome apart from the identified risk factors for surgery.