Incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection

Abstract

Background: In this study, we aimed to investigate the incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection. Methods: Between December 2010 and December 2016, a total of 40 patients (25 males, 15 females

mean age 45 +/- 41 days

range, 2 days to 6 months) who underwent total anomalous pulmonary venous connection repair were retrospectively analyzed. Results: Eighteen (45\%) of the patients were supracardiac, seven (17.5\%) were cardiac, eight (20\%) were infracardiac, and seven (17.5\%) were mixed-type anomaly. Twelve patients (30\%) had obstruction of the pulmonary venous pathways. Hospital mortality was seen in three patients (7.5\%). All of non-survivors received emergent surgery and the causes of death were sepsis and multiple organ failure. A total of 23 complications were seen in 20 patients (50\%) mainly delayed sternal closure (n=11

27.5\%) and prolonged mechanical ventilation (n=6

15\%). The mean follow-up was 12.2 +/- 9.6 (range, 1 to 36) months in all patients, except one. Pulmonary vein stenosis developed in three patients (8.3\%) after repair. All of them underwent sutureless repair. Conclusion: Total anomalous pulmonary venous connection can be repaired with low mortality and morbidity rates and favorable mid-term outcomes. Close follow-up is necessary due to the risk of development of pulmonary vein stenosis. Sutureless repair may provide relief in such cases.