1. Comparison between two surgical techniques to repair TAPVC at a single institute Shenzhen Children’s Hospital, China Dr. Yiqun Ding Guangdong Cardiovascular Institute, China Dr. Jian Zhuang et al.

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3. Challenging TAPVC Postoperative pulmonary hypertension Pulmonary venous obstruction

4. Sutureless technique Avoid PV intimal injury Prevent fibrous proliferative response

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6. 179 pt. (Supra-, Infra-, Mixed) TAPVC 98 pt. Conventional 81 pt. Sutureless Surgeon 1 Surgeon 2 Surgeon 3 Surgeon 4 Surgeon 5

7. Surgeons Perioperative managements Era Iatrogenic factors

8. Basic characteristics Cardiac type of TAPVC TAPVC with single-ventricle physiology Patients and disease influence factors

9. Preoperative pulmonary venous obstruction

10. 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

11. 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

12. Free from death and PPVO (without Preoperative PVO)

13. Free from death and PPVO (with Preoperative PVO)

14. Sutureless technique A better option

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

16. Thank you

17. 1 year follow-up

18. 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%

19. 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%