Department of Anesthesiology and Intensive Care, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland.
Department of Cardiothoracic Surgery, The Children's Memorial Health Institute, 04-736 Warsaw, Poland.
Medicina (Kaunas). 2022 May 23;58(5):687. doi: 10.3390/medicina58050687.
Over the years, surgical repair of total anomalous pulmonary venous connection (TAPVC) outcomes have improved, however, morbidity and mortality still remain significant. This study aims to assess the early and long-term outcomes of surgical treatment of TAPVC children, operated on between 2006 and 2016, in one pediatric center in Poland. : Diagnostics, surgical treatment, and follow-up data from 83 patients were collected. In addition, survival and risk factor analyses, control echocardiographic, and electrocardiographic examinations were performed. : In the analyzed group ( = 83), there were seven hospital deaths (within 30 days after the operation) (8.4%) and nine late deaths (10.8%). The mean follow-up time was 5.5 years, and, for patients who survived, it was 7.1 years. The mean survival time in patients with completed follow-up ( = 70) was 10.3 years; the overall five-year survival rate was 78.4%. Independent mortality risk factors were type I TAPVC, single ventricle physiology, time from admission to operation, intensive care unit stay, postoperative hospital stay, and temporary kidney insufficiency requiring dialysis. : The presence of single ventricle physiology and the supracardiac subtype of TAPVC might be negative prognostic factors, while normal heart physiology presents with good post-repair results. This study indicates that cardiac arrhythmias may occur. Morbidity and mortality, related to surgical TAPVC correction, still remain significant.
多年来，全肺静脉异位连接（TAPVC）的手术修复效果有所改善，但发病率和死亡率仍然很高。本研究旨在评估波兰一家儿科中心在 2006 年至 2016 年间对 TAPVC 患儿进行手术治疗的早期和长期结果。方法：收集了 83 名患者的诊断、手术治疗和随访数据。此外，还进行了生存和危险因素分析、对照超声心动图和心电图检查。结果：在分析的组中（n=83），有 7 例院内死亡（术后 30 天内）（8.4%）和 9 例晚期死亡（10.8%）。平均随访时间为 5.5 年，对于存活的患者为 7.1 年。完成随访的患者（n=70）的平均生存时间为 10.3 年；总体 5 年生存率为 78.4%。独立的死亡危险因素是 I 型 TAPVC、单心室生理、从入院到手术的时间、重症监护病房停留时间、术后住院时间和需要透析的临时肾功能不全。结论：单心室生理和 TAPVC 的心上型可能是负面的预后因素，而正常的心脏生理表现出良好的修复后结果。本研究表明可能会发生心律失常。与手术 TAPVC 矫正相关的发病率和死亡率仍然很高。
