Erek Ersin, Suzan Dilek, Aydın Selim, Hesenov Ramal, Temur Bahar, Kırat Barış, Yıldız Okan, Demir İbrahim Halil, Ödemiş Ender
Department of Pediatric Cardiac Surgery, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.
Department of Anesthesiology and Reanimation, Acibadem Atakent Hospital, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Oct 23;27(4):471-477. doi: 10.5606/tgkdc.dergisi.2019.17303. eCollection 2019 Oct.
In this study, we aimed to investigate the incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection.
Between December 2010 and December 2016, a total of 40 patients (25 males, 15 females; mean age 45±41 days; range, 2 days to 6 months) who underwent total anomalous pulmonary venous connection repair were retrospectively analyzed.
Eighteen (45%) of the patients were supracardiac, seven (17.5%) were cardiac, eight (20%) were infracardiac, and seven (17.5%) were mixed-type anomaly. Twelve patients (30%) had obstruction of the pulmonary venous pathways. Hospital mortality was seen in three patients (7.5%). All of non-survivors received emergent surgery and the causes of death were sepsis and multiple organ failure. A total of 23 complications were seen in 20 patients (50%) mainly delayed sternal closure (n=11; 27.5%) and prolonged mechanical ventilation (n=6; 15%). The mean follow-up was 12.2±9.6 (range, 1 to 36) months in all patients, except one. Pulmonary vein stenosis developed in three patients (8.3%) after repair. All of them underwent sutureless repair.
Total anomalous pulmonary venous connection can be repaired with low mortality and morbidity rates and favorable mid-term outcomes. Close follow-up is necessary due to the risk of development of pulmonary vein stenosis. Sutureless repair may provide relief in such cases.
在本研究中，我们旨在调查完全性肺静脉异位连接修复术后肺静脉狭窄的发生率及治疗情况。
回顾性分析2010年12月至2016年12月期间共40例行完全性肺静脉异位连接修复术的患者（男性25例，女性15例；平均年龄45±41天；范围为2天至6个月）。
18例（45%）患者为心上型，7例（17.5%）为心内型，8例（20%）为心下型，7例（17.5%）为混合型畸形。12例患者（30%）存在肺静脉通路梗阻。3例患者（7.5%）出现院内死亡。所有非幸存者均接受了急诊手术，死亡原因是脓毒症和多器官功能衰竭。20例患者（50%）共出现23种并发症，主要为延迟胸骨闭合（n = 11；27.5%）和机械通气时间延长（n = 6；15%）。除1例患者外，所有患者的平均随访时间为12.2±9.6（范围为1至36）个月。3例患者（8.3%）在修复术后发生肺静脉狭窄。他们均接受了无缝合修复。
完全性肺静脉异位连接可以通过低死亡率和发病率以及良好的中期结果进行修复。由于存在肺静脉狭窄发展的风险，密切随访是必要的。在这种情况下，无缝合修复可能会有所帮助。
