Total anomalous pulmonary venous connection: Results of surgical repair of 100 patients at a single institution Angela M. Kelle, BS, Carl L. Backer,

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Total anomalous pulmonary venous connection: Results of surgical repair of 100 patients at a single institution Angela M. Kelle, BS, Carl L. Backer, MD, Jeffrey G. Gossett, MD, Sunjay Kaushal, MD, PhD, Constantine Mavroudis, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 6, Pages 1387-1394.e3 (June 2010) DOI: 10.1016/j.jtcvs.2010.02.024 Copyright © 2010 Terms and Conditions

Figure 1 Kaplan–Meier curve showing the time to death after initial repair. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1387-1394.e3DOI: (10.1016/j.jtcvs.2010.02.024) Copyright © 2010 Terms and Conditions

Patient who has supracardiac TAPVC and is on CPB with bicaval venous cannulation. The aorta has been crossclamped, and cold blood cardioplegia has been delivered. The surgeon is standing on the left side of the table, and the assistant is retracting the apex of the heart toward the right shoulder of the patient. The inferior vena cava and superior vena cava have been snared. The dotted lines indicate the 2 incisions to be made: 1 in the left atrium and 1 in the common pulmonary vein. There is a snare around the vertical vein that is superior to the left pulmonary artery. The vertical vein is ligated just before opening the common pulmonary vein. Reprinted with permission: Mavroudis C, Backer CL, eds. Pediatric Cardiac Surgery. 3rd ed. Philadelphia, PA: Mosby, Inc; 2003. LV, Left ventricle; LAA, left atrial appendage; Ao, aorta; LPA, left pulmonary artery; VV, vertical vein; IVC, inferior vena cava; RPV, right pulmonary vein; LLPV, left lower pulmonary vein; LUPV, left upper pulmonary vein. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1387-1394.e3DOI: (10.1016/j.jtcvs.2010.02.024) Copyright © 2010 Terms and Conditions

An anastomosis performed in a parachute-type fashion between the left atrium and the common pulmonary vein. In most patients, a widely patent anastomosis such as this can be achieved. Note that the incision in the common pulmonary vein does not extend into the branches of the pulmonary veins themselves. The vertical vein has been ligated. Reprinted with permission: Mavroudis C, Backer CL, eds. Pediatric Cardiac Surgery. 3rd ed. Mosby, Inc; 2003. LAA, Left atrial appendage; LPA, left pulmonary artery; VV, vertical vein; IVC, inferior vena cava; LLPV, left lower pulmonary vein; LUPV, left upper pulmonary vein. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1387-1394.e3DOI: (10.1016/j.jtcvs.2010.02.024) Copyright © 2010 Terms and Conditions

Flow tree summarizes the outcomes of patients with BV and functional SV anatomy. TAPVC, Total anomalous pulmonary venous connection; BV, biventricular; SV, single ventricle. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1387-1394.e3DOI: (10.1016/j.jtcvs.2010.02.024) Copyright © 2010 Terms and Conditions

Chart showing the gradient at pulmonary vein anastomosis. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1387-1394.e3DOI: (10.1016/j.jtcvs.2010.02.024) Copyright © 2010 Terms and Conditions