Dubost Clément, Pavy Carine, Maminirina Pierre, Benbrik Nadir, Baron Olivier
Medical-Surgical Department of Pediatric and Congenital Cardiology, Pediatric and Adult Congenital Cardiac Surgery, Hospital for Children and Adolescents, 7 quai Moncousu, 44093NantesCedex 1, France.
Medical-Surgical Department of Pediatric and Congenital Cardiology, Neonatal and Pediatric Cardiology, Hospital for Children and Adolescents, 7 quai Moncousu, 44093NantesCedex 1, France.
Cardiol Young. 2023 Mar;33(3):457-462. doi: 10.1017/S1047951122001184. Epub 2022 May 12.
Surgery is considered as the first-line therapeutic strategy of partial anomalous pulmonary venous connection. The Warden technique has very good short-term results. The aim of this study is to evaluate the stability of these good results over a long period of follow-up.
We reviewed all patients who underwent a Warden procedure for partial anomalous pulmonary venous connection between 1997 and 2017 in our centre. A total of 73 patients were included. The median age was 14 years (5 months-72 years). Post-operative data were obtained through our hospital network. Late follow-up data were obtained through referrals, cardiologist letters and directly from the patient.
The mean length of follow-up was 8 years and the longest time was 22 years (range, 1-22). Twenty-five percent of our cohort had more than 10 years of follow-up. There were no cardio-vascular deaths. Eight (11.6%) patients suffered from post-operative rhythm disturbances, 5 (7.2%) of which were permanent. Two (2.9%) patients required a pacemaker implantation. At the end of the follow-up period, only one patient remained pacemaker dependent. There were no pulmonary vein obstructions. Two (2.9%) caval vein stenosis were detected, one at 7 months and the other at 7 years. These patients were treated by angioplasty alone. Five (6.8%) patients were lost to follow-up.
The good short-term results of the Warden procedure for right partial anomalous pulmonary venous connection appear to persist in the long term, with excellent freedom from pulmonary and caval stenosis in adolescence through to adulthood.
手术被认为是部分性肺静脉异位连接的一线治疗策略。沃登技术具有非常好的短期效果。本研究的目的是评估这些良好效果在长期随访中的稳定性。
我们回顾了1997年至2017年在我们中心接受沃登手术治疗部分性肺静脉异位连接的所有患者。共纳入73例患者。中位年龄为14岁（5个月至72岁）。术后数据通过我们的医院网络获得。晚期随访数据通过转诊、心脏病专家信件并直接从患者处获得。
平均随访时间为8年，最长时间为22年（范围1至22年）。我们队列中的25%患者有超过10年的随访。无心血管死亡病例。8例（11.6%）患者术后出现心律失常，其中5例（7.2%）为永久性心律失常。2例（2.9%）患者需要植入起搏器。在随访期结束时，仅1例患者仍依赖起搏器。无肺静脉梗阻。检测到2例（2.9%）腔静脉狭窄，1例在7个月时发现，另1例在7岁时发现。这些患者仅接受了血管成形术治疗。5例（6.8%）患者失访。
沃登手术治疗右部分性肺静脉异位连接的良好短期效果似乎在长期内持续存在，从青少年到成年，肺和腔静脉狭窄的发生率极低。
