Original articleCardiovascularOutcomes After Surgical Treatment of Children With Partial Anomalous Pulmonary Venous Connection
Section snippets
Inclusion Criteria
From July 1982 to May 2006, 306 consecutive patients were operated on for PAPVC at the Toronto General Hospital and the Hospital for Sick Children in Toronto; of these, 236 (77%) were children aged younger than 18 years old. The patients were identified using the surgical database. Clinical, operative, and outcome data were abstracted from the medical records. Approval of this study was obtained from the Research Ethics Board at our institution and individual consent was waived.
Partial Anomalous Pulmonary Venous Connection Characteristics
PAPVC is the
Entire Patient Cohort
Operations for PAPVC were done in 236 children: 120 boys (51%) and 116 girls (49%). Their median age at operation was 5.3 years (range, 0.47 to 18 years), and their median weight was 17.5 kg (range, 6.3 to 60.8 kg).
PAPVC were right-sided in 214 patients (90%), left-sided in 17 (7%), and bilateral in 5 (2%). Anomalous pulmonary veins were partial in 186 patients (79%) and involved the entire lung in 50 (21%).
The most common anomaly type was right PAPVC into SVC in 175 (74%); of those, 153 (87%)
Comment
Surgical principles of PAPVC repair involve separation of the pulmonary and systemic venous returns. A special consideration during surgical repair is the intimate relationship between the orifices of the anomalous pulmonary veins and the SVC or the IVC. Therapeutic options for repair of PAPVC vary with the type of anomaly and include creation of an intracardiac baffle to redirect pulmonary venous return to the left atrium or direct connection of the anomalous pulmonary vein to the left atrium [
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