Clinical Nomogram for Predicting the Prognosis of Patients With Pulmonary Venous Obstruction After Total Anomalous Pulmonary Venous Connection Repair

Ling Chen,Xingfeng Chen,Zhihuang Qiu,Fan Xu,Liangwan Chen

doi:10.3389/fcvm.2022.733253

Abstract

BackgroundThe aim of this study was to establish a nomogram to quantify the risk of postoperative pulmonary venous obstruction (PVO) and to make a scientific decision through the decision curve.MethodsIn total, 151 PVO patients with total anomalous pulmonary venous connection (TAPVC) repair in our hospital from December 2008 to December 2015 were involved in this study. A nomogram was generated based on the contribution weights of variables, which were found out by logistic analysis. The optimal clinical decision point was determined by the decision analysis and clinical impact curve, which could assess the net benefit between the nomogram and each independent risk factor for postoperative PVO.ResultPulmonary venous obstruction with TAPVC repair was found to be positively and independently correlated with preoperative pulmonary hypertension, surgical methods, and preoperative pulmonary venous stenosis.Conclusion(s)The study introduced a novel model to aid in clinical decisions making for the patients with TAPVC individually, which may shed light on the evaluation of PVO risk.

Highlights

The goal of surgical repair of total anomalous pulmonary venous connection (TAPVC) is to establish a channel connection between the pulmonary venous confluence and the left atrium
Preoperative pulmonary venous stenosis was associated with 38 cases (25.2%)
The results showed that severe stenosis or occlusion, moderate and severe pulmonary hypertension were the important risk factors of pulmonary venous obstruction (PVO)

Summary

Introduction

The goal of surgical repair of total anomalous pulmonary venous connection (TAPVC) is to establish a channel connection between the pulmonary venous confluence and the left atrium. Postoperative pulmonary venous obstruction (PVO) associated with TAPVC is a serious postoperative complication of this procedure. Data on the prognosis of all patients born with TAPVC in the United Kingdom, Ireland, and Sweden over a period of 7 years (n = 422) were reported. Postoperative PVO was found to be an important risk factor for death, occurring in 71 (17.5%) of 406 patients who underwent repair of TAPVC. The aim of this study was to establish a nomogram to quantify the risk of postoperative pulmonary venous obstruction (PVO) and to make a scientific decision through the decision curve

Objectives

Methods

Results