title: Individual Pulmonary Veins Outgrow Somatic Growth After Primary Sutureless Repair for Total Anomalous Pulmonary Venous Drainage.
abstract: Indications of sutureless repair (SR) for pulmonary vein anomalies have evolved from re-operational SR for pulmonary vein stenosis after the repair of total anomalous pulmonary venous drainage (TAPVD) to primary SR for TAPVD associated with right atrial isomerism or isolated TAPVD with small individual pulmonary veins (IPVs) and an unfavorable pulmonary vein anatomy. We sought to determine whether small IPVs outgrow somatic growth after primary SR. Between 2004 and 2013, 21 children underwent primary SR for TAPVD: 13 with a functionally single ventricle, 11 with right atrial isomerism, six with isolated TAPVD, and 13 with a pulmonary venous obstruction. TAPVD types were supracardiac in nine, infracardiac in 10, and mixed in two. Utilizing cardiac computed tomography (CT), the maximal diameter of each IPV was measured, and pulmonary vein index (PVI, summation of cross-sectional areas of all four IPVs divided by body surface area) was calculated. There were five early deaths after SR. Among survivors, 10 had both preoperative and postoperative cardiac CT at a 3.6-month median interval. On postoperative cardiac CT, IPVs were patent in all patients except one who developed a left lower pulmonary vein obstruction. There was a 71 ± 48 % postoperative increase in the actual diameter of all four IPVs, and PVI increased significantly from 215 ± 55 to 402 ± 117 mm(2)/m(2) (P value = 0.005). IPVs outgrew somatic growth after primary SR of TAPVD. Primary SR may be a useful measure in TAPVD patients whose IPVs are small.
authors.affiliation: Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors.forename: Hyun-Jin
authors.initials: HJ
authors.lastname: Jung
authors.affiliation: Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Bang
authors.affiliation: Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors.forename: Chun-Soo
authors.initials: CS
authors.lastname: Park
authors.affiliation: Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors.forename: Jeong-Jun
authors.initials: JJ
authors.lastname: Park
authors.affiliation: Seoul Women's College of Nursing, Seoul, Republic of Korea.
authors.forename: Yu-Mi
authors.initials: YM
authors.lastname: Im
authors.affiliation: Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea. tjyun@amc.seoul.kr.
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Yun
mesh_terms: D005260:Female; D059446:Heterotaxy Syndrome / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D011183:Postoperative Complications; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000601:surgery; D011668:Pulmonary Veno-Occlusive Disease / Q000601:surgery*; D012086:Reoperation; D056910:Republic of Korea; D012587:Scimitar Syndrome / Q000150:complications* / Q000601:surgery*; D000071062:Sutureless Surgical Procedures; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Pulmonary vein; Right atrial isomerism; Sutureless repair; Total anomalous pulmonary venous drainage