Abstract
Background: This study explores the strategy and effect of emergency
surgical treatment for total anomalous pulmonary venous connection
(TAPVC). Methods: From March 2009 to February 2020, 78 patients with
TAPVC underwent emergency surgical correction. There were 51 males and
27 females. The median age was 39.5 days, and the median weight was 4.0
kg. The preoperative percutaneous oxygen saturation was 80.8±4.5%.
Results: Of the cases investigated, seven died during the perioperative
period, 16 had delayed chest closure, 19 had early pulmonary vein
obstruction, two had secondary tracheal intubation, one had a brain
complication, and one had third-degree atrioventricular block. Low
weight, younger age, cardiopulmonary bypass time, and aortic cross-clamp
time were identified as risk factors for early mortality. During the
follow-up from four to 137 months, 12 cases did not respond to follow
up. Ten patients died within one to six months after discharge. One
patient underwent reoperation due to pulmonary vein obstruction. The
longer hospital stays after operation and intensive care unit time were
identified as risk factors for late mortality. Conclusions: Emergency
surgery for severe TAPVC patients after admission had achieved good
results in the near future. Prenatal diagnosis should be strengthened to
save more patients. The higher late mortality rate indicates that such
patients should strengthen post-discharge management to reduce the
occurrence of post-discharge deaths.