Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1387
5
1
gregorian
2008
8
1
22
2
online
1
fulltext
en
Midterm results after surgical correction of total anomalous pulmonary venous connection
Cardiovascular Surgery
Cardiovascular Surgery
Original Research
Original Research
<p> <strong> Abstract </strong></p><p> <strong> Objective: </strong>To evaluate the surgical treatment of total anomalous pulmonary venous </p><p> connection (TAPVC) and determination of predictors for postoperative death. </p><p> Methods: Between 1995 and 2005, 80 patients aged from 1 month to 12 years underwent surgical repair for supracardiac (39), cardiac (34), infracardiac (3) or mixed (4) type of TAPVC. Systemic pulmonary hypertension (PH) in 53.8% of patients, half systemic PH in 26.3% and mild pH (<40 mmHg) were found by preoperative evaluations. Twelve patients (15%) had some degree of pulmonary vein obstruction preoperatively. </p><p> <strong> Results: </strong>Seven patients (8.7%) died in the operating room. Early postoperative mortality </p><p> (during 48 hours) occurred in 11 cases (13.7%) and nine patients died during first </p><p> hospitalization. We did not have late mortality in survivors during follow-up period </p><p> therefore the overall mortality rate was 33.8%. The incidence of postoperative death was </p><p> highest in the infracardiac type (2/3). Approximately two-thirds of dead patients (21/27) </p><p> had presented with systemic PH and 89% of them had at least half-systemic PH preoperatively. Mortality rate in patients with normal pulmonary artery pressure (PAP) was zero. </p><p> <strong> Conclusion: </strong>In contrast to early surgical results we had excellent mid-term outcome. </p><p> The role of myocardial protection and surgical technique are the most probable causes </p><p> of high death rate in our series. However influences of poor preoperative stabilization </p><p> process as well as anesthetic technique and cardiopulmonary bypass related problems </p><p> should be considered. PAP more than half of systemic pressure and patient age smaller </p><p> than 3 months were the primary predictive factors for premature death (P<0.05). </p><p> </p>
: total anomalous pulmonary venous connection, pulmonary hypertension,mortality.
74
79
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-46&slc_lang=en&sid=1
Maziar
Gholampour-Dehaki
drgholampour@yahoo.com.
20031947532846001596
20031947532846001596
Yes
Vali-Asr Ave. , Next to Mellat Park, Rajaee Heart Center, Department of CardiovascularSurgery, Tehran, Iran.
Alireza
Alizadeh Ghavidel
20031947532846001597
20031947532846001597
No
Rajaee Heart Center, Department of Cardiovascular Surgery, Tehran, Iran.
Nader
Givtaj
20031947532846001598
20031947532846001598
No
Rajaee Heart Center, Department of Cardiovascular Surgery, Tehran, Iran.