Abstract
Objective. To evaluate the late results of surgical treatment of the patients with isolated total anomalous pulmonary venous connection (TAPVC).
Material and methods. There were included 106 patients with isolated TAPVC and biventricular physiology, operated from 2001 to 2020. The impact of preoperative, intraoperative and early postoperative factors at late surgical results was estimated. The cut-off values of risk factors for late mortality were analyzed as well.
Results. The postoperative pulmonary venous obstruction was revealed in 17 (16%) patients (median time of observation was 38,5 (16,8; 76,5) months after surgery). Overal mortality in late postoperative period after primary TAPVC surgery was 9,4% (10 patients). The postoperative pulmonary venous (PV) bloodflow velocity at the time of discharge correlated with formation of postoperative pulmonary venous obstruction after primary TAPVC surgery. The postoperative PV bloodflow velocity at the time of discharge more 1,5 m/s increased risk of postoperative pulmonary venous obstruction formation in 9,7 times, late mortality risk – in 9,3 times. In a patients with postoperative pulmonary venous obstruction the late mortality was 58,8%.
Conclusion. The postoperative pulmonary venous obstruction is a main reason of late mortality after surgery of isolated TAPVC with biventricular physiology. The postoperative PV bloodflow velocity at the time of discharge is important diagnostic and prognostic factor of postoperative pulmonary venous obstruction formation and late mortality. The first 6–12 month after surgery is an very important period of time for dynamic postoperative evaluation and timely detection of postoperative pulmonary venous obstruction, especially for high patients with the postoperative PV bloodflow velocity at the time of discharge more 1,5 m/s.
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About the authors
- Aleksandr A. Morozov, Cand. Med. Sci., Cardiovascular Surgeon; ORCID
- Ruben R. Movsesyan, Dr. Med. Sci., Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Cardiac Surgery, Professor of Chair of Pediatrics and Pediatric Cardiology; ORCID
- Maksim V. Boriskov, Cand. Med. Sci., Head of Department of Cardiac Surgery; ORCID
- Vyacheslav A. Belov, Head of Department of Cardiac Surgery No 3, Cardiovascular Surgeon; ORCID
- Pavel V. Teplov, Head of Department of Cardiac Surgery No 4, Cardiovascular Surgeon; ORCID
- Aleksandr K. Latypov, Cand. Med. Sci., Head of Department of Cardiovascular Surgery for Children; ORCID
- Evgeniy V. Grekhov, Cand. Med. Sci., Head of Research Group of Pediatric Cardiac Surgery; ORCID
- Il’ya A. Tkachenko, Cardiovascular Surgeon; ORCID
- Aleksandr Yu. Miller, Cardiovascular Surgeon; ORCID
- Aleksandr M. Titov, Cardiovascular Surgeon; ORCID
- Vadim P. Didyk, Cardiovascular Surgeon, ORCID
