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Archivos de Pediatría del Uruguay

Print version ISSN 0004-0584On-line version ISSN 1688-1249

Abstract

RIOS, Mateo et al. Total anomalus pulmonary venous connection: 25 years experience in one health center. Arch. Pediatr. Urug. [online]. 2018, vol.89, n.6, pp.374-381. ISSN 0004-0584.  http://dx.doi.org/10.31134/ap.89.6.3.

Introduction:

in the last 20 years mortality rates of patients with Total Anomalous Pulmonary Venous Connection undergoing surgical repair has improved significantly.

Objective:

this study aims at reviewing Total Anomalous Pulmonary Venous Connection post-surgical results over a 25-year period in one Health Center.

Materials and methods:

descriptive study of all patients that underwent surgical repair from Jan 1991 to Dec 2016. Seventy-one cases were identified. The data was retrieved from clinical records. Forty-seven were males. Median age was 2.8 months (range 1 day to 30 months of age) and the median weight was 4kg (range 2.1 to 10.9 kg).

Results:

forty-nine cases were supradiaphragmatic and 22 infradiaphragmatic. Drainage obstruction was present in 35 patients. Thirty-one received surgery during the neonatal period, 10 died (32%). Single-ventricle and Heterotaxy Syndrome were present in 6 cases and all of them died after surgery. Post-surgical drainage obstruction took place in 12 patients, 10 underwent re-intervention and only one survived. Overall mortality was 31%, 35% during the first 15 years period, eventhough it dropped to 20% in the last 10 years.

Conclusions:

there has been a significant improvement in mortality rates in the last ten years. Neonatal age, complex congenital heart disease and venous drainage obstruction prior to surgery were factors linked to higher mortality rates. Post-surgical pulmonary venous obstruction had a high mortality rate.

Keywords : Congenital heart defects; Toracic surgery.

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