Treatment strategies of vertical vein during correction for total anomalous pulmonary venous connection in newborns_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Xiaohua ,  CHEN Jimei , XIE Ciyan , QIU Hailong ,  CEN Jianzheng , WEN Shusheng , XU Gang ,  ZHUANG Jian

Department of Cardiac Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510080, P.R.China;

Corresponding?author：

CHEN Jimei, Email: jimei@hotmail.com

Keywords：

Total anomalous pulmonary venous connection; vertical vein; newborn; surgery; treatment

DOI：

10.7507/1007-4848.202003012

Video：

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Objective To compare the effect of different treatment strategies of vertical vein on the postoperative efficacy of total anomalous pulmonary venous connection (TAPVC) in newborns.Methods The clinical data of 72 TAPVC newborns who underwent correction in our hospital from June 2008 to January 2018 were retrospectively analyzed. There were 59 males and 13 females, with an average age of 9.93±8.13 d. According to different vertical vein treatment strategies, the patients were divided into an unligated group (22 patients), a partially ligated group (23 patients) and a completely ligated group (27 patients). The mortality and incidence of common complications among the groups were compared.Results In the completely ligated group, the aortic cross-clamp time was longer (P=0.001), intraoperative circulatory arrest cases were less (P=0.005), and the early velocity of pulmonary vein was faster (P=0.029), but there was no significant difference in the velocity of pulmonary vein for the last follow-up among three groups (P=0.393). There was no significant difference in other perioperative indicators among groups, including the early mortality, the incidence of pulmonary vein obstruction and the non-closure of vertical vein after surgery (P>0.05). The mean follow-up time was 4.47±2.63 years. The follow-up mortality was not significantly different among groups (P>0.05). The cardiac function (NYHA) of all the 64 survived patients was classⅠ-Ⅱ.Conclusion Proper vertical vein treatment strategies may be conducive to a smooth transition after surgery, ensuring the success of surgeries.

Citation： LI Xiaohua, CHEN Jimei, XIE Ciyan, QIU Hailong, CEN Jianzheng, WEN Shusheng, XU Gang, ZHUANG Jian. Treatment strategies of vertical vein during correction for total anomalous pulmonary venous connection in newborns. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(6): 640-644. doi: 10.7507/1007-4848.202003012 Copy

1.	Herlong JR, Jaggers JJ, Ungerleider RM. Congenital Heart Surgery Nomenclature and Database Project: pulmonary venous anomalies. Ann Thorac Surg, 2000, 69(4 Suppl): S56-S69.
2.	St Louis JD, Harvey BA, Menk JS, et al. Repair of "simple" total anomalous pulmonary venous connection: a review from the Pediatric Cardiac Care Consortium. Ann Thorac Surg, 2012, 94(1): 133-137.
3.	Seale AN, Uemura H, Webber SA, et al. Total anomalous pulmonary venous connection: morphology and outcome from an international population-based study. Circulation, 2010, 122(25): 2718-2726.
4.	Shi G, Zhu Z, Chen J, et al. Total anomalous pulmonary venous connection: The current management strategies in a pediatric cohort of 768 patients. Circulation, 2017, 135(1): 48-58.
5.	Chowdhury UK, Airan B, Malhotra A, et al. Mixed total anomalous pulmonary venous connection: anatomic variations, surgical approach, techniques, and results. J Thorac Cardiovasc Surg, 2008, 135(1): 106-116.
6.	Chowdhury UK, Malhotra A, Kothari SS, et al. A suggested new surgical classification for mixed totally anomalous pulmonary venous connection. Cardiol Young, 2007, 17(4): 342-353.
7.	Sarita? B, Celik M, Tatar T, et al. The outcome of the vertical vein left intact during the surgery for total anomalous venous connection and its effects on ventricular functions. Anadolu Kardiyol Derg, 2011, 11(7): 638-642.
8.	Chowdhury UK, Subramaniam KG, Joshi K, et al. Rechanneling of total anomalous pulmonary venous connection with or without vertical vein ligation: results and guidelines for candidate selection. J Thorac Cardiovasc Surg, 2007, 133(5): 1286-1294.
9.	Tweddell JS. The vertical vein: to ligate or not to ligate. J Thorac Cardiovasc Surg, 2007, 133(5): 1135-1136.
10.	Caspi J, Pettitt TW, Fontenot EE, et al. The beneficial hemodynamic effects of selective patent vertical vein following repair of obstructed total anomalous pulmonary venous drainage in infants. Eur J Cardiothorac Surg, 2001, 20(4): 830-834.
11.	Cope JT, Banks D, Mcdaniel NL, et al. Is vertical vein ligation necessary in repair of total anomalous pulmonary venous connection? Ann Thorac Surg, 1997, 64(1): 23-28, 29.
12.	Yong MS, d'Udekem Y, Robertson T, et al. Outcomes of surgery for simple total anomalous pulmonary venous drainage in neonates. Ann Thorac Surg, 2011, 91(6): 1921-1927.
13.	Zhao K, Wang H, Wang Z, et al. Early- and intermediate-term results of surgical correction in 122 patients with total anomalous pulmonary venous connection and biventricular physiology. J Cardiothorac Surg, 2015, 10: 172.
14.	李曉華, 陳澤文, 陳寄梅, 等. Sutureless技術在新生兒完全性肺靜脈異位引流中的應用. 中國胸心血管外科臨床雜志, 2017, 24(9): 661-666.
15.	Shah MJ, Shah S, Shankargowda S, et al. L-->R shunt: a serious consequence of TAPVC repair without ligation of vertical vein. Ann Thorac Surg, 2000, 70(3): 971-973.
16.	Hancock Friesen CL, Zurakowski D, Thiagarajan RR, et al. Total anomalous pulmonary venous connection: an analysis of current management strategies in a single institution. Ann Thorac Surg, 2005, 79(2): 596-606.

1. Herlong JR, Jaggers JJ, Ungerleider RM. Congenital Heart Surgery Nomenclature and Database Project: pulmonary venous anomalies. Ann Thorac Surg, 2000, 69(4 Suppl): S56-S69.
2. St Louis JD, Harvey BA, Menk JS, et al. Repair of "simple" total anomalous pulmonary venous connection: a review from the Pediatric Cardiac Care Consortium. Ann Thorac Surg, 2012, 94(1): 133-137.
3. Seale AN, Uemura H, Webber SA, et al. Total anomalous pulmonary venous connection: morphology and outcome from an international population-based study. Circulation, 2010, 122(25): 2718-2726.
4. Shi G, Zhu Z, Chen J, et al. Total anomalous pulmonary venous connection: The current management strategies in a pediatric cohort of 768 patients. Circulation, 2017, 135(1): 48-58.
5. Chowdhury UK, Airan B, Malhotra A, et al. Mixed total anomalous pulmonary venous connection: anatomic variations, surgical approach, techniques, and results. J Thorac Cardiovasc Surg, 2008, 135(1): 106-116.
6. Chowdhury UK, Malhotra A, Kothari SS, et al. A suggested new surgical classification for mixed totally anomalous pulmonary venous connection. Cardiol Young, 2007, 17(4): 342-353.
7. Sarita? B, Celik M, Tatar T, et al. The outcome of the vertical vein left intact during the surgery for total anomalous venous connection and its effects on ventricular functions. Anadolu Kardiyol Derg, 2011, 11(7): 638-642.
8. Chowdhury UK, Subramaniam KG, Joshi K, et al. Rechanneling of total anomalous pulmonary venous connection with or without vertical vein ligation: results and guidelines for candidate selection. J Thorac Cardiovasc Surg, 2007, 133(5): 1286-1294.
9. Tweddell JS. The vertical vein: to ligate or not to ligate. J Thorac Cardiovasc Surg, 2007, 133(5): 1135-1136.
10. Caspi J, Pettitt TW, Fontenot EE, et al. The beneficial hemodynamic effects of selective patent vertical vein following repair of obstructed total anomalous pulmonary venous drainage in infants. Eur J Cardiothorac Surg, 2001, 20(4): 830-834.
11. Cope JT, Banks D, Mcdaniel NL, et al. Is vertical vein ligation necessary in repair of total anomalous pulmonary venous connection? Ann Thorac Surg, 1997, 64(1): 23-28, 29.
12. Yong MS, d'Udekem Y, Robertson T, et al. Outcomes of surgery for simple total anomalous pulmonary venous drainage in neonates. Ann Thorac Surg, 2011, 91(6): 1921-1927.
13. Zhao K, Wang H, Wang Z, et al. Early- and intermediate-term results of surgical correction in 122 patients with total anomalous pulmonary venous connection and biventricular physiology. J Cardiothorac Surg, 2015, 10: 172.
14. 李曉華, 陳澤文, 陳寄梅, 等. Sutureless技術在新生兒完全性肺靜脈異位引流中的應用. 中國胸心血管外科臨床雜志, 2017, 24(9): 661-666.
15. Shah MJ, Shah S, Shankargowda S, et al. L-->R shunt: a serious consequence of TAPVC repair without ligation of vertical vein. Ann Thorac Surg, 2000, 70(3): 971-973.
16. Hancock Friesen CL, Zurakowski D, Thiagarajan RR, et al. Total anomalous pulmonary venous connection: an analysis of current management strategies in a single institution. Ann Thorac Surg, 2005, 79(2): 596-606.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Treatment strategies of vertical vein during correction for total anomalous pulmonary venous connection in newborns

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