Comparison between two surgical techniques to

repair TAPVC at a single institute

Shenzhen Children’s Hospital, ChinaDr. Yiqun Ding

Guangdong Cardiovascular Institute, ChinaDr. Jian Zhuang et al.

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Challenging TAPVC

•Postoperative pulmonary hypertension

•Pulmonary venous obstruction

Sutureless technique•Avoid PV intimal injury•Prevent fibrous proliferative

response

... ...

179 pt.179 pt.(Supra-, Infra-, (Supra-, Infra-,

Mixed)Mixed)TAPVCTAPVC

98 pt.98 pt.ConventionalConventional

81 pt.81 pt.SuturelessSutureless

Surgeon 1Surgeon 1Surgeon 2Surgeon 2Surgeon 3Surgeon 3

Surgeon 4Surgeon 4Surgeon 5Surgeon 5

•Surgeons•Perioperative managements•Era

Iatrogenic factors

•Basic characteristics•Cardiac type of TAPVC•TAPVC with single-ventricle

physiology

Patients and disease influence factors

Preoperative pulmonary venous

obstruction

Mortality•WITHOUT preoperative PVO•Sutureless: 1.8% (1/57)•Conventional: 8.6% (6/70)•p=0.199

•WITH preoperative PVO•Sutureless: 12.5% (3/24)•Conventional: 46.4% (13/28)•P<0.01

Postoperative PVO•WITHOUT preoperative PVO•Sutureless: 1.8% (1/57)•Conventional: 10% (7/70)•P=0.07

•WITH preoperative PVO•Sutureless: 4.2% (1/24)•Conventional: 25% (7/28)•p=0.06

Free from death and PPVO(without Preoperative PVO)

Free from death and PPVO(with Preoperative PVO)

Sutureless technique

A better option

Key points•Fully relieve preoperative PVO•Atriopericardial anastomosis•“no touch” suturing technique

Thank you

1 year follow-up

Survival rate•WITH preoperative PVO•Sutureless group: 21/24, 87.5%•Conventional group: 15/28, 53.6%

•WITHOUT preoperative PVO•Sutureless group: 1/57, 1.8%•Conventional group: 6/70, 8.6%

Free from PPVO•WITH preoperative PVO•Sutureless group: 23/24, 95.8%•Conventional group: 21/28, 75%

•WITHOUT preoperative PVO•Sutureless group: 56/57, 98.2%•Conventional group: 63/70, 90%