Article: Fate of the unligated vertical vein after repair of supracardiac anomalous pulmonary venous connection

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TitleFate of the unligated vertical vein after repair of supracardiac anomalous pulmonary venous connection
AuthorsCheung, YF1
Lun, KS1
Chau, AKT1
Chiu, CSW1
Issue Date2005
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPC
CitationJournal Of Paediatrics And Child Health, 2005, v. 41 n. 7, p. 361-364 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1440-1754.2005.00632.x
AbstractObjective: To determine the fate of the unligated vertical vein after repair of isolated supracardiac total anomalous pulmonary venous connection (TAPVC). Methods: We reviewed the outcome of 28 patients who were diagnosed to have isolated supracardiac TAPVC and determined the fate of the unligated vertical vein. Results: Of the 28 patients, four died before surgery. The remaining 24 patients underwent surgical correction of TAPVC with (M = 5) or without (n = 19) ligation of vertical vein at a median age of 20 days (range: 1-574 days). There were no significant differences in age, weight, presence of pulmonary venous obstruction, need for preoperative inotropic and ventilatory support, cardiopulmonary bypass duration, postoperative pulmonary hypertensive crisis and requirement of peritoneal dialysis between patients with and those without vertical vein ligation. The in-hospital surgical mortality was 50% (12/24), with 83% (10/12) of deaths occurring before 1990. Patients who died after surgery were significantly younger (median age: 5.5 days vs 37 days, P = 0.005), lighter (3.3 ± 0.5 kg vs 3.9 ± 0.6 kg, P = 0.016), more likely to have pulmonary venous obstruction preoperatively (75% vs 12%, P = 0.039) and have undergone surgery before 1990 (83% vs 33%, P = 0.036). The 12 survivors were followed up for a median of 4.7 years (range: 2.3-18.1 years), 10 of whom had their vertical vein unligated. The vertical vein remained patent in five (50%) patients, while stenosis of pulmonary venous anastomosis was only present in one patient. Of these five patients, three had subsequently undergone surgical ligation of the vertical vein to eliminate a large left-to-right shunt. Conclusions: Patency of the unligated vertical vein is common after the repair of supracardiac TAPVC, even in the absence of pulmonary venous obstruction. The degree of left-to-right shunt through the patent vertical vein may be so significant as to warrant surgical ligation.
ISSN1034-4810
2011 Impact Factor: 1.281
2011 SCImago Journal Rankings: 0.091
DOIhttp://dx.doi.org/10.1111/j.1440-1754.2005.00632.x
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorCheung, YF
dc.contributor.authorLun, KS
dc.contributor.authorChau, AKT
dc.contributor.authorChiu, CSW
dc.date.accessioned2012-10-30T06:07:39Z
dc.date.available2012-10-30T06:07:39Z
dc.date.issued2005
dc.description.abstractObjective: To determine the fate of the unligated vertical vein after repair of isolated supracardiac total anomalous pulmonary venous connection (TAPVC). Methods: We reviewed the outcome of 28 patients who were diagnosed to have isolated supracardiac TAPVC and determined the fate of the unligated vertical vein. Results: Of the 28 patients, four died before surgery. The remaining 24 patients underwent surgical correction of TAPVC with (M = 5) or without (n = 19) ligation of vertical vein at a median age of 20 days (range: 1-574 days). There were no significant differences in age, weight, presence of pulmonary venous obstruction, need for preoperative inotropic and ventilatory support, cardiopulmonary bypass duration, postoperative pulmonary hypertensive crisis and requirement of peritoneal dialysis between patients with and those without vertical vein ligation. The in-hospital surgical mortality was 50% (12/24), with 83% (10/12) of deaths occurring before 1990. Patients who died after surgery were significantly younger (median age: 5.5 days vs 37 days, P = 0.005), lighter (3.3 ± 0.5 kg vs 3.9 ± 0.6 kg, P = 0.016), more likely to have pulmonary venous obstruction preoperatively (75% vs 12%, P = 0.039) and have undergone surgery before 1990 (83% vs 33%, P = 0.036). The 12 survivors were followed up for a median of 4.7 years (range: 2.3-18.1 years), 10 of whom had their vertical vein unligated. The vertical vein remained patent in five (50%) patients, while stenosis of pulmonary venous anastomosis was only present in one patient. Of these five patients, three had subsequently undergone surgical ligation of the vertical vein to eliminate a large left-to-right shunt. Conclusions: Patency of the unligated vertical vein is common after the repair of supracardiac TAPVC, even in the absence of pulmonary venous obstruction. The degree of left-to-right shunt through the patent vertical vein may be so significant as to warrant surgical ligation.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationJournal Of Paediatrics And Child Health, 2005, v. 41 n. 7, p. 361-364 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1440-1754.2005.00632.x
dc.identifier.citeulike247768
dc.identifier.doihttp://dx.doi.org/10.1111/j.1440-1754.2005.00632.x
dc.identifier.epage364
dc.identifier.issn1034-4810
2011 Impact Factor: 1.281
2011 SCImago Journal Rankings: 0.091
dc.identifier.issue7
dc.identifier.pmid16014142
dc.identifier.scopuseid_2-s2.0-22944478364
dc.identifier.spage361
dc.identifier.urihttp://hdl.handle.net/10722/170344
dc.identifier.volume41
dc.languageeng
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPC
dc.publisher.placeAustralia
dc.relation.ispartofJournal of Paediatrics and Child Health
dc.relation.referencesReferences in Scopus
dc.subject.meshAdolescent
dc.subject.meshCardiac Surgical Procedures
dc.subject.meshCardiopulmonary Bypass
dc.subject.meshChild
dc.subject.meshChild, Preschool
dc.subject.meshCoronary Angiography
dc.subject.meshFemale
dc.subject.meshHong Kong
dc.subject.meshHumans
dc.subject.meshLigation
dc.subject.meshMale
dc.subject.meshPulmonary Veins - Surgery
dc.subject.meshTreatment Outcome
dc.titleFate of the unligated vertical vein after repair of supracardiac anomalous pulmonary venous connection
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong