Objective. Surgical approach to vertical vein (VV) during repair of total anomalous pulmonary venous connection (TAPVC) remains controversial. We aimed to evaluate the effect of different approaches on immediate surgical outcomes.
Methods. Between January 2000 and September 2008, 93 patients underwent isolated TAPVC repair at our institution. Fifty-seven patients who had ascending or descending VV were included in this study. Twenty five patients (43.9%) were younger than 1 month, and 27 (47.4%) patients were between 1 and 12 months. There were 41 patients (71.9%) with supracardiac type TAPVC, 12 (21.1%) - with infracardiac type and 4 (7%) - with mixed type. VV was ligated in 45 patients (group I) and left patent in 12 (group II). There was no significant difference between patient groups in terms of age, weight, anatomical pattern and preoperative condition. In all the cases decision to ligate VV was left to discretion of the operating surgeon.
Results. Postoperative period was uncomplicated in 34 (75.6%) patients in group I and only in 2 (16.7%) patients in group II. Twelve patients (21.1%) died in the postoperative period with only 2 deaths among last 30 cases (6.7%) (p=0.007). Patent VV was shown to negatively affect survival and degree of heart failure during both univariate and multivariate analyses.
Conclusions. Results of surgery for TAPVC have significantly improved recently. In our study patent VV in the postoperative period was found to be an independent risk factor for early death.