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Pediatric Cardiology

, Volume 40, Issue 5, pp 881–891 | Cite as

Is Sutureless Technique Beneficial in the Primary Repair of Total Anomalous Pulmonary Venous Connection? A Systematic Review and Meta-Analysis

  • Yuhao Wu
  • Liangjing Xin
  • Yuehang Zhou
  • Hongyu Kuang
  • Xin Jin
  • Yonggang Li
  • Chun WuEmail author
Review Article

Abstract

A meta-analysis was performed for a comparison of outcomes between sutureless technique and conventional surgery for primary repair for total anomalous pulmonary venous connection (TAPVC). Electronic databases including PubMed, EMbase, Scopus, and Cochrane Library were searched systematically for the single-arm studies regarding sutureless repair or conventional surgery, and two-arm studies compared the outcomes of sutureless repair and conventional surgery for TAPVC. Corresponding data were extracted and the methodological quality was assessed by two reviewers independently. 26 studies were included, involving a total of 2702 patients. It was observed that compared with conventional surgery, sutureless technique was associated with a lower occurrence rate of post-operative pulmonary veins obstruction (PVO) (4.6% vs. 13.5%, OR 0.54 in favor of sutureless technique) and re-operations due to PVO (3.4% vs. 12.4%, 0.25 in favor of sutureless technique). However, meta-analyses of post-operative early (OR 0.57; 95% CI 0.27–1.19; P = 0.13), late (OR 0.37; 95% CI 0.13–1.06; P = 0.13), and overall (OR 0.61; 95% CI 0.36–1.03; P = 0.07) mortality showed no significant difference between sutureless technique and conventional surgery. Compared with conventional surgery, sutureless technique was associated with a lower occurrence rate of post-operative PVO and re-operations due to PVO. Meanwhile, post-operative early, late, and overall mortality were not statistically different between two surgical approaches. Sutureless technique is beneficial in the primary repair of TAPVC regarding post-operative PVO and re-operations due to PVO. However, the level of evidence was low and randomized controlled trials should be designed to evaluate the safety and effectiveness of sutureless technique for TAPVC.

Keywords

Congenital heart disease Total anomalous pulmonary venous connection Sutureless technique Conventional surgery Meta-analysis 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest to declare in relation to this article.

Informed Consent

This article does not require informed consent.

Research Involving Human Participants and/or Animals

This article does not contain any studies with human or animal participants performed by any of the authors.

References

  1. 1.
    Seale AN, Uemura H, Webber SA, Partridge J, Roughton M, Ho SY et al (2010) Total anomalous pulmonary venous connection: morphology and outcome from an international population-based study. Circulation 122(25):2718–2726CrossRefGoogle Scholar
  2. 2.
    Yoshimura N, Fukahara K, Yamashita A, Doki Y, Takeuchi K, Higuma T et al (2014) Current topics in surgery for isolated total anomalous pulmonary venous connection. Surg Today 44(12):2221CrossRefGoogle Scholar
  3. 3.
    Lacour-Gayet F, Rey C, Planché C (1996) Pulmonary vein stenosis. Description of a sutureless surgical procedure using the pericardium in situ. Arch Mal Coeur Vaiss 89(5):633Google Scholar
  4. 4.
    Najm HK, Caldarone CA, Smallhorn J, Coles JG (1998) A sutureless technique for the relief of pulmonary vein stenosis with the use of in situ pericardium. J Thorac Cardiovasc Surg 115(2):468–470CrossRefGoogle Scholar
  5. 5.
    Yoshimura N, Fukahara K, Yamashita A, Doki Y, Takeuchi K, Higuma T et al (2017) Surgery for total anomalous pulmonary venous connection: primary sutureless repair versus conventional repair. Gen Thorac Cardiovasc Surg 65(5):1–7CrossRefGoogle Scholar
  6. 6.
    Slim K, Nini E, Forestier D et al (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 73(9):712–716CrossRefGoogle Scholar
  7. 7.
    Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13CrossRefGoogle Scholar
  8. 8.
    Zhang C, Ou Y, Zhuang J et al (2016) Comparison of sutureless and conventional techniques to repair total anomalous pulmonary venous connection. Semin Thorac Cardiovasc Surg 28(2):473CrossRefGoogle Scholar
  9. 9.
    Shi G, Zhu Z, Chen J, Ou YQ, Hong HF, Nie ZQ et al (2016) Total anomalous pulmonary venous connection: the current management strategies in a pediatric cohort of 768 patients. Circulation 135(1):48CrossRefGoogle Scholar
  10. 10.
    Yamashita K, Hoashi T, Kagisaki K, Kurosaki K, Shiraishi I, Yagihara T et al (2014) Midterm outcomes of sutureless technique for postoperative pulmonary venous stenosis. Gen Thorac Cardiovasc Surg 62(1):48–52CrossRefGoogle Scholar
  11. 11.
    Rito ML, Gazzaz T, Wilder T et al (2015) Repair type influences mode of pulmonary vein stenosis in total anomalous pulmonary venous drainage. Ann Thorac Surg 100(2):654CrossRefGoogle Scholar
  12. 12.
    Mueller C, Dave H, Prêtre R (2013) Primary correction of total anomalous pulmonary venous return with a modified sutureless technique. Eur J Cardiothorac Surg 43(3):635–640CrossRefGoogle Scholar
  13. 13.
    Azakie A, Lavrsen MJ, Johnson NC et al (2011) Early outcomes of primary sutureless repair of the pulmonary veins. Ann Thorac Surg 92(2):666–672CrossRefGoogle Scholar
  14. 14.
    Jung HJ, Bang JH, Park CS et al (2016) Individual pulmonary veins outgrow somatic growth after primary sutureless repair for total anomalous pulmonary venous drainage. Pediatr Cardiol 37(2):290–294CrossRefGoogle Scholar
  15. 15.
    Aeba R, Katogi T, Takeuchi S et al (1997) Correction of total anomalous pulmonary venous connection of the cardiac type. Vascular 6(1):50–57Google Scholar
  16. 16.
    Imoto Y, Kado H, Asou T et al (1998) Mixed type of total anomalous pulmonary venous connection. Ann Thorac Surg 66(4):1394CrossRefGoogle Scholar
  17. 17.
    Ando M, Takahashi Y, Kikuchi T (2004) Total anomalous pulmonary venous connection with dysmorphic pulmonary vein: a risk for postoperative pulmonary venous obstruction. Interact Cardiovasc Thorac Surg 3(4):557–561CrossRefGoogle Scholar
  18. 18.
    Lemaire A, Difilippo S, Parienti JJ et al (2017) Total anomalous pulmonary venous connection: a 40 years’ experience analysis. Thorac Cardiovasc Surg 65(01):9–17Google Scholar
  19. 19.
    Kogon B, Fernandez J, Shashidharan S et al (2017) A 30-year experience with mixed-type total anomalous pulmonary venous connection: a word of caution. Cardiol Young 27(5):1–7CrossRefGoogle Scholar
  20. 20.
    Husain SA, Maldonado E, Rasch D et al (2012) Total anomalous pulmonary venous connection: factors associated with mortality and recurrent pulmonary venous obstruction. Ann Thorac Surg 94(3):825–832CrossRefGoogle Scholar
  21. 21.
    Nakayama Y, Hiramatsu T, Iwata Y et al (2012) Surgical results for functional univentricular heart with total anomalous pulmonary venous connection over a 25 year experience. Ann Thorac Surg 93(2):606–613CrossRefGoogle Scholar
  22. 22.
    Serraf A, Belli E, Roux D et al (1998) Modified superior approach for repair of supracardiac and mixed total anomalous pulmonary venous drainage. Ann Thorac Surg 65(5):1391–1393CrossRefGoogle Scholar
  23. 23.
    Kirshbom PM, Myung RJ, Gaynor JW et al (2002) Preoperative pulmonary venous obstruction affects long-term outcome for survivors of total anomalous pulmonary venous connection repair. Ann Thorac Surg 74(5):1616–1620CrossRefGoogle Scholar
  24. 24.
    Yong MS, D’Udekem Y, Robertson T et al (2011) Outcomes of surgery for simple total anomalous pulmonary venous drainage in neonates. Ann Thorac Surg 91(6):1921–1927CrossRefGoogle Scholar
  25. 25.
    Hoashi T, Kagisaki K, Kurosaki K et al (2015) Intrinsic obstruction in pulmonary venous drainage pathway is associated with poor surgical outcomes in patients with total anomalous pulmonary venous connection. Pediatr Cardiol 36(2):432–437CrossRefGoogle Scholar
  26. 26.
    Liufu R, Shi G, Zhu F et al (2018) Superior approach for supracardiac total anomalous pulmonary venous connection. Ann Thorac Surg 32(1):12–16Google Scholar
  27. 27.
    Sagat M, Omeje IC, Nosal M et al (2008) Long-term results of surgical treatment of total anomalous pulmonary venous drainage in children. Bratisl Lek Listy 109(9):400Google Scholar
  28. 28.
    Karaci AR, Harmandar B, Aydemir NA et al (2012) Early and intermediate term results for surgical correction of total anomalous pulmonary venous connection. J Card Surg 27(3):376–380CrossRefGoogle Scholar
  29. 29.
    Cheung YF, Lun KS, Chau AK et al (2005) Fate of the unligated vertical vein after repair of supracardiac anomalous pulmonary venous connection. J Paediatr Child Health 41(7):361–364CrossRefGoogle Scholar
  30. 30.
    Kelle AM, Backer CL, Gossett JG et al (2010) Total anomalous pulmonary venous connection: results of surgical repair of 100 patients at a single institution. J Thorac Cardiovasc Surg 139(6):1387–1394.e3CrossRefGoogle Scholar
  31. 31.
    Choudhary SK, Bhan A, Sharma R et al (2001) Total anomalous pulmonary venous connection: surgical experience in Indians. Indian Heart J 53(6):754–760Google Scholar
  32. 32.
    Youngok L, Yong CJ, Young KO et al (2016) Outcomes of surgery for total anomalous pulmonary venous return without total circulatory arrest. Korean J Thorac Cardiovasc Surg 49(5):337–343CrossRefGoogle Scholar
  33. 33.
    Friesen CLH, Zurakowski D, Thiagarajan RR et al (2005) Total anomalous pulmonary venous connection: an analysis of current management strategies in a single institution. Ann Thorac Surg 79(2):596CrossRefGoogle Scholar
  34. 34.
    Honjo O, Atlin CR, Hamilton BC, Al-Radi O, Viola N, Coles JG et al (2010) Primary sutureless repair for infants with mixed total anomalous pulmonary venous drainage. Ann Thorac Surg 90(3):862–868CrossRefGoogle Scholar
  35. 35.
    Yun TJ, Al-Radi OO, Adatia I, Caldarone CA, Coles JG, Williams WG et al (2006) Contemporary management of right atrial isomerism: effect of evolving therapeutic strategies. J Thorac Cardiovasc Surg 131(5):1108–1113CrossRefGoogle Scholar
  36. 36.
    Yanagawa B, Alghamdi AA, Dragulescu A, Viola N, Al-Radi OO, Mertens LL ,et al (2011) Primary sutureless repair for “simple” total anomalous pulmonary venous connection: midterm results in a single institution. J Thorac Cardiovasc Surg 141(6):1346–1354CrossRefGoogle Scholar
  37. 37.
    Yee ES, Turley K, Hsieh WR et al (1987) Infant total anomalous pulmonary venous connection: factors influencing timing of presentation and operative outcome. Circulation 76:Iii83–I7Google Scholar
  38. 38.
    Greeley WJ, Ungerleider RM, Smith LR et al (1989) The effects of deep hypothermic cardiopulmonary bypass and total circulatory arrest on cerebral blood flow in infants and children. J Thorac Cardiovasc Surg 97:737–745Google Scholar
  39. 39.
    Rungatscher A, Luciani GB, Linardi D et al (2017) Temperature variation after rewarming from deep hypothermic circulatory arrest is associated with survival and neurologic outcome. Ther Hypothermia Temp Manag 7(2):101–106CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yuhao Wu
    • 1
    • 4
    • 5
    • 6
  • Liangjing Xin
    • 2
  • Yuehang Zhou
    • 1
    • 4
    • 5
    • 6
  • Hongyu Kuang
    • 3
    • 4
    • 5
    • 6
  • Xin Jin
    • 1
    • 4
    • 5
    • 6
  • Yonggang Li
    • 1
    • 4
    • 5
    • 6
  • Chun Wu
    • 1
    • 4
    • 5
    • 6
    Email author
  1. 1.Department of Cardiothoracic SurgeryChildren’s Hospital of Chongqing Medical UniversityChongqingChina
  2. 2.Department of OrthodonticsStomatological hospital of Chongqing Medical UniversityChongqingChina
  3. 3.Department of CardiologyChildren’s Hospital of Chongqing Medical UniversityChongqingChina
  4. 4.Ministry of Education Key Laboratory of Child Development and DisordersChongqingChina
  5. 5.China International Science and Technology Cooperation Base of Child Development and Critical DisordersChongqingChina
  6. 6.Chongqing Key Laboratory of PediatricsChongqingChina

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