PMID: 9423094Jun 1, 1994Paper

Reoperation after correction of total anomalous pulmonary venous connection: particularly for postoperative pulmonary vein stenosis

Rinshō Kyōbu Geka = Japanese Annals of Thoracic Surgery
M YokotaT Tsuda

Abstract

Postoperative pulmonary vein stenosis is a major complication after the correction of the total anomalous pulmonary venous connection. Six patients developed this complication 2 to 3 months after surgery. Five underwent reoperation (3 had the third operations) with only one survivor. Risk factors for developing the stenosis were 1. small common pulmonary vein with small branches occurring in the patients with the ages at the operation below 2 days and accordingly with the infradiaphragmatic connection and 2. Y-shaped common pulmonary vein with the confluence situated far below the left atrium. Turbulence seemed the major cause of the intimal thickening occurring in the common pulmonary vein shortly distant from the orifices of the branches. Typically the anastomotic orifice was not narrowed. Relief of the stenosis was done by the excision of the hypertrophied intimal tissue frequently cutting into the branches. Severe stenosis recurred in 4 patients necessitating another operation in 3 patients which was fatal in two. Prevention is important. Creation of a large anastomosis with the incision not extending into the branches and the use of the absorbable suture materials were effective. In the infradiaphragmatic connection incorp...Continue Reading

Related Concepts

Related Feeds

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.