Surgical treatment on venous connection of total anomalous pulmonary for neonates

Objective: Summarise the analysis of experience and effect of surgical treatment of total anomalous pulmonary venous connection (TAPVC) on neonates. Method: there were 54 patients of neonates TAPVC selected from March, 2011 to March, 2015, among the surgical treatments in our department, including 33 males and 21 females. Operation age is 6 days -28 days (15+/-4.6) days, weight is 2.6-4.5 kg (3.7+/-0.96) kg. Among them, 33 patients are supracardiac type (28 patients' vertical veins were located on the left, and 5 patients' were located on the right), 3 patients are infracardiac type, 16 patients re inner-acardiac type, and 1 patient is mixed type. Supracardiac type and parts of the infracardiac type of TAPVC in which the veins meet in the middle of the chest, so that the pulmonary vein can be routed through the diaphragm as side-to-side anastomosis, and another part of infracardiac type TAPVC adopts the treatment of left atrial anastomosis, ligature or cutting transfixion of the vertical vein. Inner-acardiac type and mixed type TAPVC adopt right axillary incision, which can fully cut down the top of coronary vein and left atrium and atrial septum, so that the pulmonary vein and left atrium can be connected smoothly, meanwhile, the top of the coronary vein shall be separated from the top of the left atrium. Extracorporeal circulation time is 39-143 min, with average time (78.76+/-27.17) min; aorta blocking time is 21-73 min, with average time (37.71+/-10.51) min. Result: Routine placement of cardiac pacemakers was in operation. Operate 19 cases. There were 4 cases of early death after the operation (7.4%). There were 8 cases of low cardiac output syndrome, 4 cases of arrhythmia, and 7 cases of pneumonia. 51 cases of child patients were followed up for periods ranging from 1 month to 3 years. No deaths and child patients for the anastomose operation again due to stenostomia, cardiac ultrasound examination shows that the blood speed of anastomose is lower than 1.4 m/s. Conclusion: During the neonates period, TAPVC patients were satisfied with the clinical effect of surgical treatment.