ECMO support for postoperative Total anomalous pulmonary venous connection: A single-center retrospective study

Abstract

Background Total anomalous pulmonary venous connection (TAPVC) is a rare congenital cardiac defect with high mortality rates, ranging from 9–30%. Surgical repair is the primary treatment, but postoperative complications such as arrhythmias, pulmonary hypertension, and pulmonary vein obstruction persist. Extracorporeal membrane oxygenation (ECMO) has emerged as a critical tool for managing complex cardiac cases, including TAPVC. Methods This retrospective study analyzed patients who received ECMO support postoperatively for TAPVC at Shanghai Children's Medical Center between January 2017 and December 2021. Inclusion criteria were children diagnosed with TAPVC and treated with ECMO. Data on demographics, surgical procedures, ECMO duration, complications, and outcomes were collected. The study followed the Helsinki Declaration. Results A total of 14 TAPVC patients were included, with a median age of 89.5 days and weight of 4.95 kg. The ECMO weaning rate was 85.71%, and the survival rate was 50%. The weaning and survival rates for intracardiac TAPVC were better than other subtypes. Further grouped showed that the high lactate status before ECMO (p = 0.00031) and the fluctuation of APTT value (p = 0.0011) during the ECMO period had predictive significance for the long-term prognosis of these children. Conclusion ECMO support is an effective therapy for TAPVC patients facing postoperative complications. Higher pre-ECMO lactate levels and fluctuations in APTT values during ECMO were predictive of long-term prognosis.