Surgical Outcomes of Total Anomalous Pulmonary Venous Connection Repair
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patient Cohort
2.3. Surgical Data
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Feature | Total (n = 83); Mean (SD; Range) or Number (%) | Normal Heart Physiology (n = 67); Mean (SD; Range) or Number (%) | Single Ventricle Physiology (n = 16); Mean (SD; Range) or Number (%) | p-Value |
---|---|---|---|---|
Gender (male) | 57 (68.7%) | 45 (67.2%) | 12 (75%) | 0.388 |
Age at operation (days) | 13 (43.9; 1–205) | 15 (47.5; 1–205) | 10.5 (19.3; 3–63) | 0.492 |
Weight (kg) | 3.4 (0.9; 1.7–6.7) | 3.5 (0.9; 1.8–6.7) | 3 (0.6; 1.7–4) | 0.039 |
TAPVC subtype: | ||||
| 37 (44.6%) 14 (16.9%) 28 (33.7%) 4 (4.8%) | 30 (44.8%) 13 (19.4%) 20 (29.9%) 4 (6%) | 7 (43.8%) 1 (6.3%) 8 (50%) − (0%) | 0.28 |
Restrictive TAPVC * | 69 (83.1%) | 57 (85.1%) | 12 (75%) | 0.265 |
Time from admission to operation (days) | 8.4 (16.2; 0–99) | 6.9 (15; 0–99) | 14.8 (20; 0–61) | 0.162 |
Feature | Total (n = 83); Mean (SD; Range) or Number (%) | Normal Heart Physiology (n = 67); Mean (SD; Range) or Number (%) | Single Ventricle Physiology (n = 16); Mean (SD; Range) or Number (%) | p-Value |
---|---|---|---|---|
CPB time (min.) | 152 (68.3; 45–441) | 147 (70; 45–441) | 176 (57; 74–305) | 0.016 |
AoX time (min.) | 53.5 (20.4; 21–118) | 56 (20.4; 21–118) | 43 (16.7; 27–78) | 0.015 |
Use of DHCA | 73 (88%) | 57 (85.1%) | 16 (100%) | 0.102 |
DHCA time (min.) | 47.9 (18.2; 20–104) | 52 (18.1; 20–104) | 33 (7.2; 22–52) | 0.004 |
Delayed sternal closure | 36 (43.4%) | 26 (38.8%) | 10 (6.3%) | 0.086 |
Complications (all): | 50 (60.3%) | 34 (50.8%) | 16 (100%) | <0.001 |
| 45 (54.2%) | 29 (43.3%) | 16 (100%) | <0.001 |
| 31 (37.4%) | 19 (28.4%) | 12 (75%) | 0.001 |
| 13 (15.7%) | 8 (11.9%) | 5 (31.3%) | 0.056 |
| 10 (12.1%) | 6 (9%) | 4 (25%) | 0.095 |
Postoperative mechanical ventilation time (hours) | 291 (443.8; 1–2750) | 180 (213.6; 1–1080) | 757 (767.7; 4–2750) | <0.001 |
ICU stay (days) | 17 (29.5; 0–205) | 9 (10.6; 0–49) | 49 (54.3; 0–205) | <0.001 |
Postoperative hospital stay (days) | 26 (29; 0–206) | 19 (11.9; 1–62) | 54 (52.8; 0–206) | <0.001 |
Univariate Analysis | Multivariate Analysis | |||||
---|---|---|---|---|---|---|
Covariate | HR | 95%CI | p-Value | HR | 95%CI | p-Value |
Preoperative features | ||||||
Age (days) | 0.996 | 0.952–1.01 | 0.531 | |||
Newborn | 1.975 | 0.562–6.939 | 0.289 | |||
Gender | 0.598 | 0.192–1.857 | 0.374 | |||
Restrictive TAPVC * | 1.067 | 0.304–3.745 | 0.92 | |||
TAPVC subtype | 0.742 | 0.442–1.247 | 0.261 | |||
Supracardiac (I) vs. others (II, III, and IV) subtype of TAPVC | 2.568 | 0.932–7.076 | 0.068 | 3.61 | 1.258–10.356 | 0.017 |
Intracardiac (II) vs. others (I, III, and IV) subtype of TAPVC | 0.037 | 0–9.201 | 0.241 | |||
Infracardiac (III) vs. others (I, II, and IV) subtype of TAPVC | 0.8 | 0.278–2.303 | 0.679 | |||
Mixed (IV) vs. others (I, II, and II subtype) of TAPVC | 0.965 | 0.127–7.308 | 0.972 | |||
Single ventricle physiology | 9.125 | 3.326–25.04 | <0.001 | 9.126 | 3.259–25.553 | <0.001 |
Weight (kg) | 0.643 | 0.324–1.277 | 0.207 | |||
Weight below 3 kg | 2.242 | 0.834–6.025 | 0.109 | 2.064 | 0.737–5.783 | 0.168 |
Intra- and postoperative features | ||||||
Time from admission to operation (days) | 1.015 | 0.996–1.034 | 0.114 | 1.657 | 1.273–2.156 | <0.001 |
Postoperative mechanical ventilation time (hours) | 1.001 | 1–1.002 | 0.001 | 0.999 | 0.998–1.001 | 0.313 |
ICU stay (days) | 1.013 | 1.005–1.021 | 0.001 | 1.624 | 1.256–2.1 | <0.001 |
Postoperative hospital stay (days) | 1.014 | 1.006–1.022 | 0.001 | 0.608 | 0.468–0.791 | <0.001 |
Postoperative complications (overall) | 63.366 | 1.112–3612.041 | 0.044 | 0.122 | 0–146+ | 0.99 |
Postoperative mechanical ventilation over seven days | 73.552 | 1.297–4141.414 | 0.037 | 14020.79 | 0–146+ | 0.955 |
Temporary kidney insufficiency requiring dialysis | 34.693 | 4.565–263.661 | 0.001 | 38.376 | 2.976–494.831 | 0.005 |
Postoperative arrythmia | 2.964 | 1.016–8.645 | 0.047 | 2.534 | 0.445–14.425 | 0.295 |
Major infections | 0.607 | 0.08–4.595 | 0.628 | |||
Delayed sternum closure | 1.538 | 0.575–4.114 | 0.392 | |||
CPB time (min.) | 1.007 | 1.001–1.012 | 0.013 | 1.003 | 0.994–1.011 | 0.544 |
AoX time (min.) | 1.004 | 0.98–1.029 | 0.741 | |||
Use of DHCA (min.) | 1.853 | 0.244–14.045 | 0.551 | |||
DHCA time (min.) | 0.999 | 0.97–1.029 | 0.947 | |||
Need of reoperation | 2.944 | 0.667–13.007 | 0.154 | 5.906 | 0.74–47.110 | 0.094 |
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Jaworski, R.; Kansy, A.; Friedman-Gruszczynska, J.; Bieganowska, K.; Mirkowicz-Malek, M. Surgical Outcomes of Total Anomalous Pulmonary Venous Connection Repair. Medicina 2022, 58, 687. https://doi.org/10.3390/medicina58050687
Jaworski R, Kansy A, Friedman-Gruszczynska J, Bieganowska K, Mirkowicz-Malek M. Surgical Outcomes of Total Anomalous Pulmonary Venous Connection Repair. Medicina. 2022; 58(5):687. https://doi.org/10.3390/medicina58050687
Chicago/Turabian StyleJaworski, Radoslaw, Andrzej Kansy, Joanna Friedman-Gruszczynska, Katarzyna Bieganowska, and Malgorzata Mirkowicz-Malek. 2022. "Surgical Outcomes of Total Anomalous Pulmonary Venous Connection Repair" Medicina 58, no. 5: 687. https://doi.org/10.3390/medicina58050687