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

TitleFate of the unligated vertical vein after repair of supracardiac anomalous pulmonary venous connection
Authors
Issue Date2005
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPC
Citation
Journal Of Paediatrics And Child Health, 2005, v. 41 n. 7, p. 361-364 How to Cite?
Abstract
Objective: 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.
Persistent Identifierhttp://hdl.handle.net/10722/170344
ISSN
2013 Impact Factor: 1.193
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorCheung, YFen_US
dc.contributor.authorLun, KSen_US
dc.contributor.authorChau, AKTen_US
dc.contributor.authorChiu, CSWen_US
dc.date.accessioned2012-10-30T06:07:39Z-
dc.date.available2012-10-30T06:07:39Z-
dc.date.issued2005en_US
dc.identifier.citationJournal Of Paediatrics And Child Health, 2005, v. 41 n. 7, p. 361-364en_US
dc.identifier.issn1034-4810en_US
dc.identifier.urihttp://hdl.handle.net/10722/170344-
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.en_US
dc.languageengen_US
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JPCen_US
dc.relation.ispartofJournal of Paediatrics and Child Healthen_US
dc.subject.meshAdolescenten_US
dc.subject.meshCardiac Surgical Proceduresen_US
dc.subject.meshCardiopulmonary Bypassen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCoronary Angiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHumansen_US
dc.subject.meshLigationen_US
dc.subject.meshMaleen_US
dc.subject.meshPulmonary Veins - Surgeryen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleFate of the unligated vertical vein after repair of supracardiac anomalous pulmonary venous connectionen_US
dc.typeArticleen_US
dc.identifier.emailCheung, YF:xfcheung@hku.hken_US
dc.identifier.authorityCheung, YF=rp00382en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1440-1754.2005.00632.xen_US
dc.identifier.pmid16014142en_US
dc.identifier.scopuseid_2-s2.0-22944478364en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-22944478364&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume41en_US
dc.identifier.issue7en_US
dc.identifier.spage361en_US
dc.identifier.epage364en_US
dc.identifier.isiWOS:000230302700011-
dc.publisher.placeAustraliaen_US
dc.identifier.scopusauthoridCheung, YF=7202111067en_US
dc.identifier.scopusauthoridLun, KS=8363663600en_US
dc.identifier.scopusauthoridChau, AKT=35787094400en_US
dc.identifier.scopusauthoridChiu, CSW=8714554800en_US
dc.identifier.citeulike247768-

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