title: Early- and intermediate-term results of surgical correction in 122 patients with total anomalous pulmonary venous connection and biventricular physiology.
abstract: BACKGROUND
  We retrospectively reported our 26-year experience with operative repair of total anomalous pulmonary venous connection (TAPVC) with biventricular physiology.
  
  
  METHODS
  Between December 1982 and December 2008, 122 TAPVC patients with biventricular heart underwent surgical repair in our department. Moderate or deep hypothermia was induced at the time of cardiopulmonary bypass (CPB). Follow-up was conducted for 5 postoperative years. Surgical outcomes of early and intermediate deaths after TAPVC repair were retrospectively analyzed.
  
  
  RESULTS
  Six deaths occurred operatively; and three deaths, during follow-up. The 5-year survival rates after TAPVC repair was 92.6 %, without gradient across the anastomosis. The survival rate of the patients who were younger was 78.8 %, significantly lower than those older than 1 year. It was also lower in those who were less than 6 kg in weight. Three patients died during follow-up. Three patients died of ventricular arrhythmia, right heart failure, and pneumonia, respectively, during follow-up. If the left atrium pressure was higher than 15 mm Hg, the snare of the vertical vein was loosened after CPB ceased in the patients with supracardiac connection. It decreased from 21 ± 5 to 13 ± 3 mm Hg. The vertical vein was ligated in 57 cases and left open in 20 cases. A patient with an intact vertical vein had a large shunt and was cured by intervention afterward. Supraventricular arrhythmia occurred in 19 patients with the supercardiac type repaired through a biatrial incision. One patient died of ventricular arrhythmia, and none of the remaining patients had arrhythmias.
  
  
  CONCLUSIONS
  Surgical treatment of TAPVC carried a low operative risk and had satisfactory immediate and intermediate results. Age younger than 1 year and weight less than 6 kg were risk factors. It was a good choice to leave the vertical vein open in the patients with a left atrial pressure higher than 15 mm Hg.
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China.
authors.forename: Keyan
authors.initials: K
authors.lastname: Zhao
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China. kydoccn@163.com.
authors.forename: Huishan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China.
authors.forename: Zengwei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China.
authors.forename: Hongyu
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China.
authors.forename: Minhua
authors.initials: M
authors.lastname: Fang
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China.
authors.forename: Xianyang
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China.
authors.forename: Nanbin
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Cardiac Surgery, Shenyang Northern Hospital, 83 Wenhua Road, Shenhe District, Shenyang, 110840, Liaoning Province, China.
authors.forename: Hengchang
authors.initials: H
authors.lastname: Song
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011184:Postoperative Period; D011667:Pulmonary Veins / Q000002:abnormalities / Q000601:surgery*; D012189:Retrospective Studies; D012587:Scimitar Syndrome / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000379:methods*; D016276:Ventricular Function / Q000502:physiology*; D055815:Young Adult