Abstract:
Objective; To determine factors contributing to mortality among patients of TAPVC
undergoing surgical repair at Children Hospital, Lahore.
Study Design: Descriptive case series.
Place and Duration of the Study: September 2004 to October 2009
Materials and Methods: All patients of either gender who had TAPVC and unde went
surgical repair during study period were included.
Results: In the last 4.5 years, 44 patients (29 males & 15 females) underwent repair for
total anomalous pulmonary venous connection. Ages ranged from 2 day to 9 years (median
6 & mean 17 months) and 26 of them were less than 1 year. Weight ranged from 2.4 to 20 kg
(median 5 kg). The anomalous connection was supracardiac in 21 (48%), cardiac in 10
(23%), infracardiac in 5 (11%) and mixed in 8 (18%) patients. Fifteen (34%) patients had
obstructed drainage and 21 (48%) had moderate or severe pulmonary arterial hypertension.
15 patients (34%) had to be operated upon on an emergency basis. Mortality was more in
obstructed drainage patients (40%),compared with patients without obstruction (6%).The
major causes of early death were weight < 10%ile (OR 1.1; 95% CI: 0.1-6.5, p-0.009),
obstruction (OR 9.8; 95% CI: 1.6-60, p-0.006) and sepsis (OR 23.3; 95% CI: 3 – 177, p-0.002).
Follow-up ranged from 1 to 45 months (median 24 months). There was one late death due to
late pulmonary vein stenosis and was re-operated upon and died.
Conclusions: In a developing country like Pakistan, mortality continues to be high in
infants with total anomalous pulmonary venous connection. Weight < 10 percentile,
obstruction, severe pulmonary arterial hypertension and post operative sepsis appears to
be the most important predictor of operative mortality.
Page(s):
196-199
DOI:
DOI not available
Published:
Journal: Annals of the Pakistan Institute of Medical Sciences, Volume: 8, Issue: 3, Year: 2012
Keywords:
Mortality
,
Totalanomalous
,
Pulmonaryvenous connection
,
Surgical repair