Efficacy of left atrial anastomosis for repairing infracardiac total anomalous pulmonary venous connection

Objective To evaluate the efficacy of left atrial anastomosis in repairing infracardiac total anomalous pulmonary venous connection (TAPVC). Methods From March 2012 to April 2015, 14 surgical cases of infracardiac TAPVC were reviewed. There were 9 boys and 5 girls with a mean age of (28.9±6.73)(8-42) days and a mean body weight of (3.9±1.43)(2.8-5.4) kg. Low-temperature extracorporeal circulation was performed under general anesthesia. pulmonary vein confluence-vertical vein and left and right pulmonary veins were adequately dissociated and their position relations with heart observed under a natural state. In 14 cases, pulmonary vein confluence-vertical vein was located behind left atria or interatrial septum. Pulmonary vein confluence-vertical vein was anatomosed side-to-side to left atrium through left atrium. Results All procedures were successfully completed. The mean CPB time was (118.7±22.14)(89-141) min, mean postoperative respiratory machine auxiliary time (4.19±1.04)(3-7) days and mean aortic clamping time (52.1±6.54)(46~67) min. Early mortality was 7.14%. The postoperative complications included low cardiac output syndrome (n=8), supraventricular tachycardia (n=2), pneumothorax (n=2) and pneumonia (n=7). All recovered after active interventions. Conclusions Left atrial anastomosis is both safe and effective for children with infracardiac TAPVC. Key words: Total anomalous pulmonary venous connection; Heart atria; Cardiac surgical procedures