Surgical outcomes of functional single ventricle with total anomalous pulmonary venous connection
OU Yan-qiu1
LIU Xiao-bing2
CEN Jian-zheng2
LIU Xiao-qing1
1.Department of Epidemiology,Guangdong Cardiovascular Institute,WHO Collaborating Center for Research and Training in Cardiovascular Diseases,Guangdong Provincial Key Laboratory of South China Structural Heart Disease,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510180,Guang-dong,China2.Department of Cardiac Surgery,Guangdong Cardiovascular Institute,WHO Collaborating Center for Research and Training in Cardiovascular Diseases,Guangdong Provincial Key Laboratory of South China Structural Heart Disease,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510180,Guang-dong,China
摘要：Background The surgical outcomes have been greatly improved over the past four decades for functional sin-gle ventricle(FSV). However,the repair for coexistence of FSV and total anomalous pulmonary venous connec-tion(TAPVC),especially obstructed TAPVC,has remained a clinical challenge. Little is known about the re-sults of surgical treatment for patients with FSV-TAPVC in China. Methods Forty consecutive patients with FSV-TAPVC undergoing initial surgical palliation(median age:16.8 months;body weight:8.25 kg)were ret-rospectively enrolled from 2006 to 2016 in a specialized cardiovascular institute. TAPVC was repaired in 30 pa-tients. The mean follow-up period was 49 months. Results All of the 7 patients with preoperative pulmonary vein obstruction(PVO)underwent repair of TAPVC at the first operation and survived. When a systemic to pul-monary(S-P)shunt or pulmonary artery banding(PAB)was necessary,patients with concomitant TAPVC re-pair had lower mortality (30.0％) and higher total cavopulmonary connection completion rate (20.0％) than those without TAPVC repair[75.0％ and 0％,respectively],although with no statistical significance(Fisher test,P=0.505 and P=0.245). The overall survival rates for the cohort at 1,3 and 5 years after the initial surgical intervention were 80.0％,77.1％and 77.1％,respectively. Multivariate COX regression analysis detected that S-P shunt(adjusted odds ratio:6.51;95％CI:1.26-33.71,P=0.030)is the only risk factor for survival. The rein-tervention rate for postoperative PVO was higher in patients with preoperative PVO than those without(57.1％vs. 4.3％,Log Rank:P=0.006). Conclusion The mid-term results of surgical repair of FSV-TAPVC are still challenging. When PVO exists,surgical repair for TAPVC is suggested as soon as possible. Repair for TAPVC should also be considered when S-P shunt or PAB is necessary. Further study with larger population are warrant-ed to support our finding.
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论文发表日期：2020-03-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 38-46,52 )
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