• Szu-Yen Hu, Jing-Ren Ye, Heng-Wen Chou, Yih-Sharng Chen, Chung-I Chang, Ing-Sh Chiu, Chih-Ting Lin, Hsiao-En Tsai, Shyh-Jye Chen, and Shu-Chien Huang.
• Department of Cardiovascular Surgery, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics National Taiwan University Taipei Taiwan.
• J Formos Med Assoc. 2024 Sep 5.

BackgroundTo evaluate the association between the pulmonary vein (PV) entry site morphology after total anomalous pulmonary vein repair (TAPVC) and postoperative pulmonary vein stenosis (PVS).MethodsComputed tomography (CT) examination was performed to determine the PV entry site morphology. The width of the PV confluence was divided by the width of the left atrium (LA) to obtain the cPV/LA index. The cPV/LA index was compared between patients with and without postoperative PVS.ResultsFifty-one patients who had undergone CT after TAPVC repair were included, with a median cPV/LA index of 0.5 (interquartile range (IQR) = 0.349-0.654). Among them, 27 patients developed postoperative PVS. The median cPV/LA index after primary TAPVC repair was significantly lower in patients with PVS compared to those without PVS (0.367, IQR = 0.308-0.433 vs. 0.657, IQR = 0.571-0.783, P < 0.0001). Additionally, the cPV/LA index after surgical re-intervention for PVS was significantly smaller in patients who developed recurrent stenosis compared to those who remained free-from re-stenosis after surgical relief (0.459, IQR = 0.349-0.556; vs. 0.706, IQR = 0.628-0.810, P = 0.0045).ConclusionA small PV confluence width is associated with the development of postoperative PVS and recurrent stenosis after surgical relief of PVS. Our results suggest that adequate bilateral pulmonary vein lateralization during TAPVC surgery is crucial.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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