Surgical results and factors affecting operative mortality in total anomalous pulmonary venous drainage.

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Abstract
Factors affecting the surgical results of total anomalous pulmonary venous drainage were evaluated in 17 patients in an attempt to establish and appropriate plan of management. The mortality rate correlated with age, size of interatrial communication, arterial O2 saturation and left heart volume, but not with pulmonary to systemic systolic pressure ratio, vascular resistance ratio and right ventricular volume. In cases where the symptoms appeared early in lift, left heart volume was small and clinical features were severe. Four children with a left ventricular end-diastolic volume of < 65% of normal died of low cardiac output syndrome. In those with an unusually small left heart, enlargement of the left atrium and/or delayed ligation of the anomalous vertical vein were considered more favorable. Left atrial and ventricular volumes were restored to normal after the surgery.