Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Ann Thorac Surg. 2012 Jul;94(1):133-7; discussion 137-8. doi: 10.1016/j.athoracsur.2012.03.006. Epub 2012 May 4.
Outcomes for repair of total anomalous pulmonary venous connection (TAPVC) from individual institutions suggest a significant improvement in mortality over the past several decades. The purpose of this study is to review the outcomes after repair of TAPVC from a large multiinstitutional registry.
A retrospective review of the multiinstitutional database, the Pediatric Cardiac Care Consortium (PCCC), was used to identify patients with the diagnosis of TAPVC who underwent complete correction between 1982 and 2007. Data reviewed included age, decade of primary operation, anatomic type, presentation, and in-hospital mortality.
Of the 118,084 surgical procedures submitted to the PCCC, 2,191 (1.9%) consisted of primary surgical correction of TAPVC. Sixty-one percent of the cohort was male, with 6.8% reported as premature. Overall in-hospital surgical mortality for simple TAPVC was 13%. Mortality was 20% from 1982 to 1989, 16% from 1990 to 1999, and 8% from 2000 to 2007. Obstruction to the anomalous pulmonary venous connection occurred in 29%, with a mortality of 26%.
Surgical outcomes from repair of congenital cardiac anomalies have significantly improved over the past several decades. Multiinstitutional large databases are needed to confirm results published from single-institution experiences. Although improvements in surgical repair of TAPVC have occurred over the past three decades, specific subtypes still experience significant mortality.
来自个别机构的全肺静脉异常连接（TAPVC）修复的结果表明，在过去几十年中，死亡率有了显著的改善。本研究的目的是通过大型多机构登记处审查 TAPVC 修复后的结果。
回顾性地分析了多机构数据库，即儿科心脏护理联合会（PCCC），以确定 1982 年至 2007 年间接受完全矫正的 TAPVC 诊断患者。审查的数据包括年龄、初次手术的十年、解剖类型、表现和院内死亡率。
在提交给 PCCC 的 118084 例手术中，有 2191 例（1.9%）为 TAPVC 的初次手术矫正。队列中有 61%为男性，有 6.8%为早产儿。单纯 TAPVC 的院内手术死亡率为 13%。1982 年至 1989 年死亡率为 20%，1990 年至 1999 年死亡率为 16%，2000 年至 2007 年死亡率为 8%。异常肺静脉连接梗阻发生率为 29%，死亡率为 26%。
过去几十年，先天性心脏畸形修复的手术结果有了显著的改善。需要多机构的大型数据库来确认单一机构经验发表的结果。尽管过去三十年 TAPVC 的手术修复有所改善，但特定亚型仍存在显著的死亡率。
