Sutureless technique and conventional procedure for total
anomalous pulmonary venous connection
Although the “sutureless
technique” is a common surgical procedure for postoperative PVO after
TAPVC repair (6), the indication of this technique versus the
conventional procedure for the primary repair of TAPVC is controversial
(7-9). Yamashita and colleagues reported that the sutureless technique
for postoperative PVO does not improve prognosis; however, it is
effective in PVO release (10). The sutureless technique theoretically
avoids intimal proliferation in repaired native PVs and prevents the
kinking or distortion of the anastomotic site. Several institutions
primarily apply this technique (11,12). However, no significant
difference in mortality between the primary sutureless technique and
conventional repair for simple TAPVC and single ventricle with TAPVC has
been observed (10,13). In our experience, while there were no
significant difference between the sutureless and conventional groups
(P=0.43), there was only one branch PVO in sutureless technique and one
or more branch PVOs in conventional procedure which might have caused
death from heart failure after Fontan. Our early results may not suggest
the more usefulness of the primary sutureless technique than
conventional procedure for RAI with TAPVC, including preoperative PVO (7
of 12 patients). Although both procedures were useful for TAPVC repair,
PVO can still occur and strategies to prevent it are necessary.