A modified sutureless technique treating total anomalous pulmonary venous connection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Shan , SHI Tao , TENG Xiao , YU Bing , LV Xiaodong , LI Shoujun ,  HUA Zhongdong

Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China;

Corresponding author：

HUA Zhongdong, Email: richardhua@yahoo.com

Keywords：

Modified sutureless technique; total anomalous pulmonary venous connection; surgical technique

DOI：

10.7507/1007-4848.202010074

Video：

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Objective To introduce a modified sutureless technique and its surgical results in the treatment of total anomalous pulmonary venous connection (TAPVC).Methods Clinical data of 11 patients with TAPVC who underwent the modified sutureless technique treatment from 2014 to 2019 in our center were retrospectively analyzed, including 4 males and 7 females. The median surgical age was 1.4 (0.3, 27.0) months. The median weight was 4.3 (3.5, 8.5) kg.Six (54.5%) patients were of supracardiac subtype, and five (45.5%) patients were of infracardiac subtype. Five (45.5%) patients had preoperative severe pulmonary hypertension, and three (27.3%) patients had preoperative pulmonary vein obstruction. The surgical results were compared with those of 10 patients treated with conventional surgical technique.Results The median follow-up was 12 (range, 1-65) months. During the follow-up, no death or postoperative pulmonary vein obstruction occurred in the modified sutureless technique group. The perioperative data and relief of re-obstruction were superior in the modified sutureless technique group, but the difference was not statistically significant (P>0.05). The postoperative survival of the the modified sutureless technique group was better than that of the traditional surgery group (P=0.049).Conclusion The modified sutureless technique which includes partial suture and then incising, and eversion of pulmonary vein incision, is a safe and reliable method for the treatment of TAPVC with satisfactory short-term results.

Citation： WANG Shan, SHI Tao, TENG Xiao, YU Bing, LV Xiaodong, LI Shoujun, HUA Zhongdong. A modified sutureless technique treating total anomalous pulmonary venous connection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(5): 619-623. doi: 10.7507/1007-4848.202010074 Copy

1.	Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol, 2002, 39(12): 1890-1900.
2.	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.
3.	Lacour-Gayet F, Zoghbi J, Serraf AE, et al. Surgical management of progressive pulmonary venous obstruction after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 1999, 117(4): 679-687.
4.	李晓华, 陈寄梅, 庄建, 等. Sutureless 技术在新生儿完全性肺静脉异位引流中的应用. 中国胸心血管外科临床杂志, 2017, 24(9): 661-666.
5.	Shi GC, Zhu F, Wen C, et al. Single-institution outcomes of surgical repair of infracardiac total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 2021, 161(4): 1408-1417.
6.	Lo Rito M, Gazzaz T, Wilder T, et al. Repair type influences mode of pulmonary vein stenosis in total anomalous pulmonary venous drainage. Ann Thorac Surg, 2015, 100(2): 654-662.
7.	Latson LA, Prieto LR. Congenital and acquired pulmonary vein stenosis. Circulation, 2007, 115(1): 103-108.
8.	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.
9.	Masaki N, Adachi O, Katahira S, et al. Progression of vascular remodeling in pulmonary vein obstruction. J Thorac Cardiovasc Surg, 2020, 160(3): 777-790.
10.	Kalfa D, Belli E, Bacha E, et al. Outcomes and prognostic factors for postsurgical pulmonary vein stenosis in the current era. J Thorac Cardiovasc Surg, 2018, 156(1): 278-286.
11.	Yoshimura N, Fukahara K, Yamashita A, et al. Surgery for total anomalous pulmonary venous connection: Primary sutureless repair vs. conventional repair. Gen Thorac Cardiovasc Surg, 2017, 65(5): 245-251.
12.	Wu YH, Wu ZC, Zheng JM, et al. Sutureless technique versus conventional surgery in the primary treatment of total anomalous pulmonary venous connection: A systematic review and meta-analysis. J Cardiothorac Surg, 2018, 13(1): 69-78.
13.	Menon S, Mathew T, Karunakaran J, et al. Modified closed chamber sutureless technique for anomalous pulmonary venous connection. Ann Pediatr Cardiol, 2017, 10(1): 58-60.
14.	Hammel JM, Hunt PW, Abdullah I, et al. "Closed-vein" technique for primary sutureless repair of anomalous pulmonary venous connection. Ann Thorac Surg, 2012, 94(3): 1021-1022.
15.	Alsoufi B. Modified primary sutureless repair technique of total anomalous pulmonary venous connection. World J Pediatr Congenit Heart Surg, 2014, 5(2): 302-305.

1. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol, 2002, 39(12): 1890-1900.
2. 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.
3. Lacour-Gayet F, Zoghbi J, Serraf AE, et al. Surgical management of progressive pulmonary venous obstruction after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 1999, 117(4): 679-687.
4. 李晓华, 陈寄梅, 庄建, 等. Sutureless 技术在新生儿完全性肺静脉异位引流中的应用. 中国胸心血管外科临床杂志, 2017, 24(9): 661-666.
5. Shi GC, Zhu F, Wen C, et al. Single-institution outcomes of surgical repair of infracardiac total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg, 2021, 161(4): 1408-1417.
6. Lo Rito M, Gazzaz T, Wilder T, et al. Repair type influences mode of pulmonary vein stenosis in total anomalous pulmonary venous drainage. Ann Thorac Surg, 2015, 100(2): 654-662.
7. Latson LA, Prieto LR. Congenital and acquired pulmonary vein stenosis. Circulation, 2007, 115(1): 103-108.
8. 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.
9. Masaki N, Adachi O, Katahira S, et al. Progression of vascular remodeling in pulmonary vein obstruction. J Thorac Cardiovasc Surg, 2020, 160(3): 777-790.
10. Kalfa D, Belli E, Bacha E, et al. Outcomes and prognostic factors for postsurgical pulmonary vein stenosis in the current era. J Thorac Cardiovasc Surg, 2018, 156(1): 278-286.
11. Yoshimura N, Fukahara K, Yamashita A, et al. Surgery for total anomalous pulmonary venous connection: Primary sutureless repair vs. conventional repair. Gen Thorac Cardiovasc Surg, 2017, 65(5): 245-251.
12. Wu YH, Wu ZC, Zheng JM, et al. Sutureless technique versus conventional surgery in the primary treatment of total anomalous pulmonary venous connection: A systematic review and meta-analysis. J Cardiothorac Surg, 2018, 13(1): 69-78.
13. Menon S, Mathew T, Karunakaran J, et al. Modified closed chamber sutureless technique for anomalous pulmonary venous connection. Ann Pediatr Cardiol, 2017, 10(1): 58-60.
14. Hammel JM, Hunt PW, Abdullah I, et al. "Closed-vein" technique for primary sutureless repair of anomalous pulmonary venous connection. Ann Thorac Surg, 2012, 94(3): 1021-1022.
15. Alsoufi B. Modified primary sutureless repair technique of total anomalous pulmonary venous connection. World J Pediatr Congenit Heart Surg, 2014, 5(2): 302-305.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

A modified sutureless technique treating total anomalous pulmonary venous connection

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