Journal Club: Analysis of Risk Factors Associated with Early Mortality in TAPVC Repairs - Video
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Overview
This is a recent journal article published in the Journal of Cardiac Critical Care published by Scientific Scholar.
Total anomalous pulmonary venous connection (TAPVC) is a congenital cardiac malformation. If it is not repaired surgically, the chances of survival of the patient are meager. Due to the improved perioperative care and surgical techniques, the overall results have also improved. This study assesses the risk factors in relation to early mortality in TAPVC repairs performed over a period of 10 years by a single surgeon in our institute.
Eighty-eight patients who were surgically treated for TAPVC at our institute over a period of 10 years by a single surgeon formed the basis of this retrospective observational study. The information regarding patient demographic details, pre-operative evaluation, surgical procedure, post-operative course, and follow-up after discharge was retrieved by searching operation theatre (O.T) registries, medical record sections, and finally by patient follow-up in outpatient department/telephonic follow-up.
Results showed that out of 88, 64 were male patients and 24 were female patients. About 25% of the participants had age ≤1 month. The TAPVC type was supracardiac in 46.6% cases, cardiac in 27.3%, infracardiac in 15.9%, and mixed in 10.2%).
Of the 88 TAPVC patients, 33 were obstructed at the time of operation. Twenty-nine patients had to be taken up for emergency TAPVC repair.
Thirteen patients were on mechanical ventilation preoperatively and 18 patients required pre-operative inotropic support. Mean cardiopulmonary bypass (CPB) time in our study was 63.36 min, and cross-clamp duration was 34.4 min.
Patients required to be ventilated postoperatively for an average of 4.18 days. Mean intensive care unit (ICU) and hospital stay were 8.01 days and 17.8 days respectively. Eleven patients died postoperatively. Out of these, eight had age of <1 month.
All of the 11 mortalities had at least some PAH in the post-operative period. However, 16 out of the surviving 77 patients had PAH.
Therefore, it was concluded that supracardiac type was the most common subtype of TAPVC followed by cardiac. Early mortality was 12.5%, while late mortality was 3.9%. Age <1 month, low weight at the time of surgery, pre-operative obstructed pulmonary veins, pre-operative need of mechanical ventilation, pre-operative inotrope requirement, repair of TAPVC on an emergency basis, and post-operative PAH were important risk factors for early mortality.
Ref: Murtaza SM, Prakash M, Gupta S, Devagourou V. Analysis of Risk Factors Associated with Early Mortality in Total Anomalous Pulmonary Venous Connection (TAPVC) Repairs Performed Over a Period of 10 Years – A Retrospective Observational Study. J Card Crit Care TSS. 2025;9:44-51. doi: 10.25259/JCCC_55_2024
Speakers
Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751