Warden ve Tek Çift Yama Tekniği ile Düzeltilmiş Ppvda Hastalarının Postoperatif Sonuçları

Abstract

In patients with partial anomalous pulmonary venous return (PAPVR), postoperative obstruction of pulmonary veins and vena cava, arrhythmias may occur. Aim of the study is to explore outcomes after CPB, intesive care unit and long-term follow-up of the patients with PAPVR operated with Warden and single/double patch techniques in our institution. Between 2005-2011, there were 55 patients diagnosed with PAPVR, had undergone repair at our institution. Only 20 patients accepted to be voluteer. Mean age was 5.5 years (range 5 mounth to 11 years). Twelve patients (60%) had undergone the Warden procedure and 8 (40%) had undergone single or double patch techniques. Mean follow-up duration was 39,7 months (range 3 to 82). All patients had normal sinus rhythm before operations. New onset arrhythmias had developed in 20 % of patients (n=4) in early postoperative period. Patients with early postoperative arrhythmia had significantly lower age (p=0,032) and body weight (p=0,026) than those without early postoperative arrhythmia. There was no significant difference in terms of CPB duration, the lowest body temperature and aortic clemp duration between these two groups. There was no difference in incidence of early postoperative arrhythmia between the surgical groups (Warden and single/double patch groups). There was no mortality. When patients were discharged, all had normal sinus rhythm. During the long-term follow-up no patient showed evidence of caval or pulmonary venous obstruction and arrhythmia. But two of patients (1 (5%) Scimitar syndrome,1 (5%) PAPVR-ASD) operated with single patch technique diagnosed with residual ASD and reoperated. Our findings suggest that both surgical approaches appear to be safe.