[Correction of total anomalous pulmonary venous connection in infant less than one year old].

OBJECTIVE

To evaluate the effects of early correction for total anomalous pulmonary venous connection (TAPVC) in infant under one.

METHODS

Twenty-eight infants less than one year old with TAPVC were admitted and prepared to be treated surgically from July 1995 to August 2001. Total correction was performed on 24 cases, 20 males and 4 females, aged 6.04 +/- 3.34 months, with the mean body weight of 5.74 +/- 1.22 kg, of which 10 (41.67%) being of supracardic type, 11 (45.83%) being of intracardiac type, 1 (4.17%) being of infracardiac type, and 2 (8.33%) being of mixed type. Four patients died of hypoxic attack during anteoperative preparation and failed to be operated upon.

RESULTS

Three infants (12.5%) died within 30 days after operation. One case of intracardiac type died of circulatory failure because of severe postoperative bleeding and late exploratory thoracotomy. One case of supracardiac type died of cardiac sufficiency because of bleeding at anastomotic stoma during operation. One case of mixed type died of circulatory failure because of high pressure of left cardiac atrium. All of the 4 cases who underwent emergent operation survived. The most common complication was arrhythmia (41.67%).

CONCLUSION

The early effect of early correction for TAPVC is satisfactory and its long-term effect is to be observed. A wide anastomosis between the posterior wall of the left atrium and common pulmonary vein is more important for the supracardic type. The diameters of left atrium, left ventricle and atrial septum defect have little effect on operative results. Arrhythmia after operation has no significant increase in supracardic type through. With rather high incidence rate of arrhythmia (5/8, 62.5%), the combined left atrium incision and right atrium incision approach assures a sufficiently large incision for the supracardiac type. However, this approach is statistically different in the incidence rate of arrhythmia only between supracardiac type and intracardiac type.