LES RETOURS VEINEUX PULMONAIRES ANORMAUX TOTAUX BLOQUES. FACTEURS INFLUENCANT UNE AMELIORATION DES RESULTATS CHIRURGICAUX

Translated title of the contribution: Obstruction of total anomalous pulmonary venous drainage: Factors influencing improved surgical results

A. Serraf, J. Bruniaux, F. Lacour-Gayet, P. Chambran, G. Lecronier, S. Demontoux, C. Planche*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Of 107 patients operated for total anomalous pulmonary venous drainage (TAPVD) at Marie-Lannelongue Hospital between January 1980 and November 1989, 57 had severe pulmonary venous obstruction. The average age of the patients at operation was 13.6 days and their average body weight was 3.2 kg. Twenty eight patients had an infracardiac, 23 patients a supracardiac, 2 patients an intracardiac and 4 patients a mixed type of TAPVD. The diagnosis of pulmonary venous obstruction was made on the findings of low cardiac output and pulmonary hypertension exceeding the systemic blood pressure, and on the results of angiography and Doppler echocardiography. Seventy five per cent of patients were admitted in Class IV of the NYHA Classification. Since 1985, treatment has been directed towards prevention of pulmonary hypertension. Echocardiographic diagnosis is considered sufficient for posing the surgical indication. Surgery should be performed before degradation of the patient's clinical condition or after a short period of stabilisation. The prevention of hypertensive crises in the postoperative period depends on continuous monitoring of pulmonary pressures. This approach has considerably improved our surgical results as the mortality rate has fallen from 59 p. 100 (1980-1984) to 13.3 p 100 (1985-1989)(p < 0.005). In conclusion, obstruction of the pulmonary veins in TAPVD is no longer considered to be a poor prognostic factor, providing measures are taken to prevent pulmonary hypertension before, during and after surgery.

Translated title of the contributionObstruction of total anomalous pulmonary venous drainage: Factors influencing improved surgical results
Original languageFrench
Pages (from-to)643-646
Number of pages4
JournalArchives des Maladies du Coeur et des Vaisseaux
Volume83
Issue number5
StatePublished - 1990
Externally publishedYes

Keywords

  • cardiopathie congenitale
  • chirurgie cardiaque
  • hypertension arterielle pulmonaire
  • retour veineux pulmonaire anormal bloque

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