ZHU Haiª²Long, ZHANG Jinª²Zhou, CHEN Tao, YI Dingª²Hua, SUN Guoª²Cheng, GAO Zhaoª²Bo

    Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi¬ðan 710033, China

    ¡¾Abstract¡¿ AIM: To explore surgical operation and perioperative treatment for total anomalous pulmonary venous connection (TAPVC) in infants and children. METHODS: Twentyª²nine corrective operations for TAPVC were retrospectively analysed. All patients, aging 2-35 months and weighing 2.9-14.0 kg, underwent total corrective operations with moderate hypothermia and cardiopulmonary bypass, of which 5 cases were emergency or subª²emergency. RESULTS: Two patients died (mortality 6.9%). In the period of perioperative low cardiac output occurred in 6 patients, pulmonary hypertension crisis in 1, pulmonary infection in 5 patients and diaphragmatic paralysis in 1 patient. Followª²up varied from 1 month to 8 years in 27 patients. No later death or obvious obstruction of pulmonary venous drainage were found. Twentyª²three patients were NYHA I class and 4 were II class. CONCLUSION: Corrective operations for TAPVC have to be performed as soon as diagnosis is confirmed. Particularly for severe obstruction of pulmonary venous drainage, emergent or subemergent operation is necessary. Postoperative treatment should limit fluid volume and avoid exorbitant afterload. Proper managements including cardiac, diuresis and controlling pulmonary artery pressure are helpful, especially respiratory administration and nutrition support. ......