Abstract
Introduction. The main aim of total anomalous pulmonary venous connection (TAPVC) surgery is to provide a drainage of the pulmonary veins to left atrium directly. Despite of lots of surgical approach and its modifications, the optimal surgical decision is still in search. In the present study, we estimate using of interaortocaval approach for the TAPVC surgery.
Material and methods. In this report, 36 patients with TAPVC, surgically treated with approach were included. The analysis of clinical and instrumental (transthoracic echocardiogram, computed tomography angiography) data (pre- and postoperative) was performed. The anatomical features of TAPVC and their impact on surgical method selection were studied. We also estimated our results of interaortocaval approach using for TAPVC surgery and our early and late results.
Results. The supracardiac type of TAPVC was identified in 28 patients, cardiac type – 2 patients, infracardiac – 5 patient and mix type – in 1 patient. The interaortocaval approach for the pulmonary vein to left atrium anastomosis was applied in 31 cases, in another 4 cases we used combination of superior approach and patch rechanneling of the pulmonary venous blood flow through the atrial septum, in one case – anastomosis of the left pulmonary veins to left atrium. There was no operative and early postoperative mortality. The late postoperative period was observed in 13 patients with good clinical and echocardiographic results.
Conclusion.The interaortocaval approach can be used as itself or in combination with other surgical techniques for complex pulmonary vein anatomy patients and different types of TAPVC. This approach is effective surgical method allowing to achieve good early and late results of TAPVC surgery.
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About the authors
- Aleksandr A. Morozov, Cand. Med. Sc., Cardiac Surgeon, ORCID
- Ruben R. Movsesyan, Dr. Med. Sc., Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Cardiac Surgery of Children's City Hospital # 1, Professor of Department of Pediatrics and Pediatric Cardiology, Chief Pediatric Cardiac Surgeon of the Health Committee of Saint-Petersburg ORCID
- Aleksey A. Shikhranov, Cand. Med. Sc., Cardiovascular Surgeon,
ORCID
- Evgeniy V. Grekhov, Cand. Med. Sc., Head of the Research Department of Cardiac Surgery in Children, ORCID
- Nikolay V. Antsygin, Cardiovascular Surgeon, ORCID
- Aleksandr K. Latypov, Cand. Med. Sc., Head of Department of Cardiac Surgery, ORCID
- Natal'ya V. Fedorova, Cardiologist, ORCID
- Elena S. Vasichkina, Dr. Med. Sc., Head of the Research Department of Cardiovascular Diseases in Children, Professor of the Department of Pediatric Disease, ORCID
