XXXX : long-term appraisal with evolving technical solutions.

@entity1 @entity154 @entity1700 @entity384 @entity341 @entity254 @entity3885 @entity849 @entity4032 @entity943
OBJECTIVES: To evaluate late outcome of @entity1700 (TAPVC) repair, controlling for anatomic subtypes and surgical technique. METHODS: Between 1983 and 2001, 89 @entity1 (median age 54 days) underwent repair for supracardiac (38), cardiac (26), infracardiac (16) or mixed (nine) TAPVC. Ten @entity1 (11.2%) presented @entity154 other than PDA. Twenty-eight @entity1 (31.5%) were @entity341 , due to obstructed drainage. Supracardiac and infracardiac TAPVC repair included the double-patch technique with @entity4032 in 29 @entity1 and side-to-side @entity254 between the pulmonary venous (PV) confluence and the left atrium in 29 @entity1 . Coronary sinus unroofing was preferred for cardiac TAPVC repair. Total follow-up was 727.16 @entity1 -years (mean 8.55 years, 98.8% complete). RESULTS: Early mortality was 7.86% (7/89). Ten @entity1 (11.2%) underwent reintervention, including reoperation (eight), @entity384 (one) and intraoperative stents placement (one), for anastomotic (four) or @entity849 (six), with four late deaths. Kaplan-Meier survival is 87.3+/-0.036 SE% at 18.07 years with no difference according to anatomic type or surgical technique. Freedom from PV reintervention for operative survivors is 86.7+/-0.052 SE% at 18.07 years. Cox proportional hazard indicates @entity154 (P=0.008) and reoperation for @entity849 (P=0.034) as independent predictors of mortality. According to logistic analysis, @entity3885 predicts higher risk of reintervention for @entity849 (P=0.022), while the double-patch technique increased the risk of late @entity943 (P=0.005). CONCLUSIONS: Side-to-side @entity254 provides excellent results for TAPVC repair while @entity4032 procedures appear to be associated with higher risk of late @entity943 . Although early and aggressive reintervention for recurrent @entity3885 is mandatory, @entity849 remains a predictor of adverse outcome.
