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. 1978 Jun;33(3):275–282. doi: 10.1136/thx.33.3.275

Total anomalous pulmonary venous connection (surgical technique, early and late results).

G Di Eusanio, F A Sandrasagra, R J Donnelly, D I Hamilton
PMCID: PMC470885  PMID: 684663

Abstract

Between March 1970 and October 1977, 36 patients underwent correction of total anomalous pulmonary venous connection. The ages ranged from 5 days to 16 years; 27 (75%) were under 1 year and 19 were under 3 months of age at the time of surgery. The overall mortality was 33%. Supracardiac connection was the commonest type and was associated with the lowest hospital mortality (30%). The highest mortality occurred in the mixed and infracardiac types and was related in part to the presence of associated intracardiac anomalies. The use of hypothermia and circulatory arrest in infancy has resulted in a considerably lower hospital mortality compared with cases operated on under conventional cardiopulmonary bypass. The mortality in 23 infants (under 1 year of age) was 26% using circulatory arrest and was lowest when correction was performed within the first three months of life (18%). All four infants operated on with standard cardiopulmonary bypass died, whereas this technique was found to be safe in older children. The surgical technique using a left anterolateral thoractomy with a trans-sternal extension is described. This technique gives an excellent exposure for fashioning a long anastomosis and has been associated with a low incidence of postoperative pulmonary complications. There have been no late deaths and all survivors, who are in excellent condition up to seven years after correction, have a normal exercise tolerance.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BURROUGHS J. T., KIRKLIN J. W. Complete surgical correction of total anomalous pulmonary venous connection; report of three cases. Proc Staff Meet Mayo Clin. 1956 Mar 21;31(6):182–188. [PubMed] [Google Scholar]
  2. Breckenridge I. M., De Leval M., Stark J., Waterston D. J. Correction of total anomalous pulmonary venous drainage in infancy. J Thorac Cardiovasc Surg. 1973 Sep;66(3):447–453. [PubMed] [Google Scholar]
  3. COOLEY D. A., OCHSNER A., Jr Correction of total anomalous pulmonary venous drainage: technical considerations. Surgery. 1957 Dec;42(6):1014–1021. [PubMed] [Google Scholar]
  4. CRAIG J. M., DARLING R. C., ROTHNEY W. B. Total pulmonary venous drainage into the right side of the heart; report of 17 autopsied cases not associated with other major cardiovascular anomalies. Lab Invest. 1957 Jan-Feb;6(1):44–64. [PubMed] [Google Scholar]
  5. Clarke D. R., Stark J., De Leval M., Pincott J. R., Taylor J. F. Total anomalous pulmonary venous drainage in infancy. Br Heart J. 1977 Apr;39(4):436–444. doi: 10.1136/hrt.39.4.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cooley D. A., Hallman G. L., Leachman R. D. Total anomalous pulmonary venous drainage; correction with the use of cardiopulmonary bypass in 62 cases. J Thorac Cardiovasc Surg. 1966 Jan;51(1):88–102. [PubMed] [Google Scholar]
  7. DUSHANE J. W. Total anomalous pulmonary venous connection: clinical aspects. Proc Staff Meet Mayo Clin. 1956 Mar 21;31(6):167–170. [PubMed] [Google Scholar]
  8. Engle M. A. Total anomalous pulmonary venous drainage. Success story at last. Circulation. 1972 Aug;46(2):209–211. doi: 10.1161/01.cir.46.2.209. [DOI] [PubMed] [Google Scholar]
  9. Gathman G. E., Nadas A. S. Total anomalous pulmonary venous connection: clinical and physiologic observations of 75 pediatric patients. Circulation. 1970 Jul;42(1):143–154. doi: 10.1161/01.cir.42.1.143. [DOI] [PubMed] [Google Scholar]
  10. Gomes M. M., Feldt R. H., McGoon D. C., Danielson G. K. Total anomalous pulmonary venous connection. Surgical considerations and results of operation. J Thorac Cardiovasc Surg. 1970 Jul;60(1):116–122. [PubMed] [Google Scholar]
  11. Jensen J. B., Blount S. G., Jr Total anomalous pulmonary venous return. A review and report of the oldest surviving patient. Am Heart J. 1971 Sep;82(3):387–407. doi: 10.1016/0002-8703(71)90306-1. [DOI] [PubMed] [Google Scholar]
  12. LEWIS F. J., VARCO R. L., TAUFIC M., NIAZI S. A. Direct vision repair of triatrial heart and total anomalous pulmonary venous drainage. Surg Gynecol Obstet. 1956 Jun;102(6):713–720. [PubMed] [Google Scholar]
  13. MULLER W. H., Jr The surgical treatment of transposition of the pulmonary veins. Ann Surg. 1951 Oct;134(4):683–693. doi: 10.1097/00000658-195110000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Mathew R., Thilenius O. G., Replogle R. L., Arcilla R. A. Cardiac function in total anomalous pulmonary venous return before and after surgery. Circulation. 1977 Feb;55(2):361–370. doi: 10.1161/01.cir.55.2.361. [DOI] [PubMed] [Google Scholar]
  15. Wukasch D. C., Deutsch M., Reul G. J., Hallman G. L., Cooley D. A. Total anomalous pulmonary venous return. Review of 125 patients treated surgically. Ann Thorac Surg. 1975 Jun;19(6):622–633. doi: 10.1016/s0003-4975(10)63822-2. [DOI] [PubMed] [Google Scholar]
  16. el-Said G., Mullins C. E., McNamara D. G. Management of total anomalous pulmonary venous return. Circulation. 1972 Jun;45(6):1240–1250. doi: 10.1161/01.cir.45.6.1240. [DOI] [PubMed] [Google Scholar]

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