Outcomes of total anomalous pulmonary venous drainage and predictors of mortality-Tertiary center experience

Total anomalous pulmonary venous drainage (TAPVD) is a rare congenital anomaly associated with a high mortality rate, especially when associated with complex congenital heart disease (CHD). This is a retrospective study, conducted between 2011 and 2020, aiming to document outcomes and identify predictors for mortality. A total of forty-three patients underwent repair. The mean follow-up time was 4.6 years (+/- 2.3). Thirty-five patients had isolated disease while 8 patients had complex TAPVD, 4 of which had single ventricle (SV) physiology. Pre-and postoperative pulmonary venous obstruction (PVO) were documented at 28% and 21%, respectively. The overall mortality rate was at 14% and highly associated with the SV group (p < 0.001). Multivariate analysis revealed SV physiology, cardiopulmonary bypass time, intraoperative low rectal temperatures (ILRT), and open chest (OC) as the only independent risk factors for early mortality. Conclusion: Outcomes were excellent in patients with the isolated type, but mortality remained high within the SV group. Death continues to be associated with previously identified risk factors along with ILRT and an OC. PVO was not identified as a risk factor for death, except in univariate analysis, with good outcomes following secondary repair to relieve the obstruction. Overall survival beyond hospital discharge offers excellent outcome.