title: Midterm outcomes of sutureless technique for postoperative pulmonary venous stenosis.
abstract: BACKGROUND
  The efficacy of a sutureless technique for postoperative pulmonary venous stenosis (PVS) following repair of total anomalous pulmonary venous connection (TAPVC) has been reported, though detailed clinical advantages remain unclear. We retrospectively reviewed our surgical experience, and compared outcomes between conventional procedures and a sutureless technique.
  
  
  METHODS
  For relief of postoperative PVS after TAPVC repair, five patients underwent a conventional procedure, such as orifice cutback or resection of a proliferated intima, from 1999 to 2004 (Conventional group, 4 males, median 93 days old, 3.6 kg), then seven underwent a sutureless technique (Sutureless group, 5 males, 119 days old, 3.4 kg) from 2005 to 2011. Patients with a functional single ventricle were excluded. There were no significant differences regarding patient characteristics. Follow-up examinations were completed in all patients.
  
  
  RESULTS
  The rate for cumulative survival at 5 years was 60 % in the Conventional group and 71.4 % in the Sutureless group. Re-stenosis after relief of PVS occurred in 100 % (10/10) of patients in the Conventional group and 31.6 % (6/19) of patients in the Sutureless group (p = 0.0088). For bilateral venous stenosis patients, the survival rate was 66.7 % (4/6) in the Sutureless group and 0 % (0/2) in the Conventional group (p = 0.10). Out of three patients who developed whole 4-vein stenosis, only one in the Sutureless group survived.
  
  
  CONCLUSIONS
  Although overall survival rate was similar in both groups, the Sutureless technique for postoperative PVS following TAPVC repair successfully rescued more pulmonary veins without re-stenosis than conventional procedures. Further follow-up may demonstrate therapeutic advantages.
authors.affiliation: Departments of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors.forename: Kizuku
authors.initials: K
authors.lastname: Yamashita
authors.forename: Takaya
authors.initials: T
authors.lastname: Hoashi
authors.forename: Koji
authors.initials: K
authors.lastname: Kagisaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kurosaki
authors.forename: Isao
authors.initials: I
authors.lastname: Shiraishi
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Yagihara
authors.forename: Hajime
authors.initials: H
authors.lastname: Ichikawa
mesh_terms: D003251:Constriction, Pathologic / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D011667:Pulmonary Veins / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012587:Scimitar Syndrome / Q000601:surgery*; D015996:Survival Rate; D013536:Suture Techniques
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