title: Repair of total anomalous pulmonary venous connection in early infancy.
abstract: From May 1995 through October 2001, 19 infants less than 90 days old underwent surgical correction of total anomalous pulmonary venous connection. In 15 babies with isolated total anomalous pulmonary venous connection, there was one operative death. In 4 with complex anomalies, there were 2 operative deaths. The vertical vein was not ligated in 6 cases for various reasons. Two patients died during reoperation for early pulmonary venous obstruction. In the late follow-up, 2 babies required reoperation for late anastomotic stricture; one needed additional balloon dilatation. Of the 14 surviving patients, one had a small residual gradient and infrequent supraventricular tachycardia, the others were asymptomatic and without gradients. Surgical correction of total anomalous pulmonary venous connection can be carried out in early infancy with low mortality and morbidity. However, associated complex cardiac anomalies and small caliber pulmonary arteries and veins carry higher risks. Recurrent pulmonary venous obstruction and diffuse pulmonary vein stenosis are causes of early reoperation and poor surgical outcome.
authors.affiliation: Department of Cardiac Surgery, Al Mafraq Hospital, Abu Dhabi, UAE.
authors.forename: Dharmapuram
authors.initials: D
authors.lastname: Anil Kumar
authors.forename: Raghavan Nair Suresh
authors.initials: RN
authors.lastname: Kumar
authors.forename: Pantula
authors.initials: P
authors.lastname: Narasinga Rao
authors.forename: Hassan Mohamed
authors.initials: HM
authors.lastname: Mahmoud
authors.forename: Sushil
authors.initials: S
authors.lastname: Chandran
authors.forename: Achal Kumar
authors.initials: AK
authors.lastname: Dhir
authors.forename: Dileep Kumar
authors.initials: DK
authors.lastname: Saxena
authors.forename: Sivan Pillay
authors.initials: SP
authors.lastname: Azhagappan
authors.forename: Velayudhan Ramakrishna
authors.initials: VR
authors.lastname: Pillai
authors.forename: Chokkanathapura Gopalakrishnan
authors.initials: CG
authors.lastname: Venkitachalam
authors.forename: Mohamed Amin
authors.initials: MA
authors.lastname: Fikree
authors.forename: Yoosuph Abdul
authors.initials: YA
authors.lastname: Nazer
authors.forename: Timothy Boyd
authors.initials: TB
authors.lastname: Cartmill
authors.forename: Ivatury
authors.initials: I
authors.lastname: Mrutyunjaya Rao
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008026:Ligation / Q000379:methods; D008297:Male; D011667:Pulmonary Veins / Q000503:physiopathology* / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome