title: The research on operation of obstructed total anomalous pulmonary venous connection in neonates.
abstract: OBJECTIVE
  Total anomalous pulmonary venous connection (TAPVC) is a rare congenital heart disease. This study aimed to evaluate the outcomes of TAPVC repair in neonates, controlling for anatomic subtypes and surgical techniques.
  
  
  METHODS
  Between 1997 and 2013, 88 patients (median age: 16 days) underwent repair for supracardiac (31), cardiac (18), infracardiac (36), or mixed (3) TAPVC. All the patients underwent emergency operation due to obstructed drainage. Supracardiac and infracardiac TAPVC repair included a side-to-side anastomosis between the pulmonary venous confluence and left atrium. Coronary sinus unroofing was preferred for cardiac TAPVC repair.
  
  
  RESULTS
  The early mortality rate was 2.3% (2/88 patients). The echocardiogram showed no obstruction in the pulmonary vein anastomosis, and flow rate was 1.1-1.42 m/s in the 3-year follow-up period.
  
  
  CONCLUSIONS
  The accurate preoperative diagnosis, improved protection of heart function, use of pulmonary vein tissue to anastomose and avoid damage of the pulmonary vein, and delayed sternum closure can reduce the risk of mortality. The preoperative severity of pulmonary vein obstruction, the timing of the emergency operation, and infracardiac or mixed-type TAPVC can affect prognosis. Using our surgical technique, the TAPVC mortality among our patients was gradually reduced with remarkable results. However, careful monitoring of the patient with pulmonary vein restenosis and the timing and method of reoperation should also be given importance.
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Medical College, Affiliated with Shanghai Jiaotong University, Shanghai 200127, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Jinghao
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Medical College, Affiliated with Shanghai Jiaotong University, Shanghai 200127, China.
authors.forename: Gao
authors.initials: G
authors.lastname: Botao
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Medical College, Affiliated with Shanghai Jiaotong University, Shanghai 200127, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhiwei
authors.affiliation: Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Medical College, Affiliated with Shanghai Jiaotong University, Shanghai 200127, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Jinfeng
mesh_terms: D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000601:surgery*; D012189:Retrospective Studies
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