Surgical Treatment And Follow-up Research For Partial Anomalous Pulmonary Venous Connection Of A Single Center

Objective:We retrospectively analyzed the surgical treatment and outcome of 121 patients with partial anomalous pulmonary venous connection(PAPVC),comparing the survival rate,physical activity and postoperative complications of PAPVC patients in the near and middle stage.By comparing the early and mid-term outcomes of different surgical patients,the aim to optimize surgical techniques,further reduce the incidence of postoperative complications and improve the survival rate.Methods:From February 2012 to August 2018,the Yan 'an Hospital affiliated to Kunming Medical University operated on 125 patients with partial anomalous pulmonary venous connection,18 cases with complex heart diseases including RASV,PECD,RHD and TOF were removed.There were 121 cases of simple PAPVC or simple heart malformations with ASD.Basic preoperative data were collected,including gender,age,symptoms,complications,electrocardiogram,anatomy of pulmonary vein,and echocardiography.In terms of surgical details,attention should be paid to surgical methods,aortic clamp time and cardiopulmonary bypass time.Postoperative data included mechanical ventilation time,ICU stay time,hospital stay,first postoperative review results and postoperative follow-up data.Then we analyze the survival rate,quality of life and postoperative complications.Results:From February 2012 to August 2018,a total of 121 patients(54 males and 67 females)with PAPVC and simple malformation were treated by surgery in our hospital.Among them,62(51%)were children under the age of 18.The surgical age ranged from 4-61 years,mean 23.28±16.44 years.There were 59 cases(49%)of supracardiac type,54 cases(45%)of cardiac type,4 cases(3%)of infracardiac type and 4 cases(3%)of mixed type.The vast majority of patients had different degrees of pulmonary hypertension and right ventricular enlargement before surgery.Of the 121 cases,80 were repaired by single-patch method,22 by double-patch technique,4 by Warden technique,and 15 by direct anastomosis technique,with no early or late death.The mean duration of cardiopulmonary bypass time and aortic clamp time was 88.38±44.51 min and 55.36±30.27 min.The ventilation time?intense time and hospital stay time were 15.2±7.5h,40.81±10.78h and 18.8±5.8d,respectively.All patients recovered well and were discharged in stable condition.111 cases were followed up regularly,10 cases were lost,the follow-up rate was 91.73%,and the follow-up time was 1-7 years.One patient underwent delayed sternotomy due to intraoperative ventricular fibrillation.Two patients underwent re-sternotomy for hemostasis in the operating room due to posterior sternal wall bleeding.All patients have not died since discharge.Postoperative complications appear short supraventricular arrhythmia in 11 cases,?°atrioventricular block on temporary pacemaker in 1 case,postoperative mild cerebral infarction in 1 case,7 cases of postoperative lower quality of life.Patients were not found any severe vena cava or pulmonary vein stenosis.Conclusion:PAPVC has a low incidence of postoperative complications and no mortality.Therefore,surgical repair of this heart malformation is a safe and reliable treatment.Surgical techniques must be selected based on anatomy and possible concomitant congenital heart defects for developping a personalized surgical plan.With the improvement of surgical techniques,the incidence of postoperative complications of patients continue to decline,and the quality of life is gradually improved.