DOI: https://doi.org/10.36347/sasjs.2026.v12i01.012

Pages: 69-76

Introduction: Total Anomalous Pulmonary Venous Drainage (TAPVD) constitutes approximately 1.5% of all congenital heart defects. Surgical correction has traditionally been performed using the conventional technique, however, the sutureless approach has emerged as a recent alternative. This study aims to compare the surgical outcomes of the two techniques and to identify the variables influencing them. Methodology: This was a retrospective study over a 17-year period from 2007 to 2024. There were 55 patients of TAPVD-supracardiac (n=32), intracardiac (n=18), infracardiac (n=3) and mixed (n=2), Results: Median age of surgical intervention was 43 days (IQR 30,120), median weight of 3.40 kg (IQR 3.00,4.30). Prematurity was present in 3 patients (5.5%), 11(19.6%) had pre-operative pulmonary vein obstruction, 2(3.6%) had Atrial septal defect (ASD) obstruction, 23 (41.1%) had pre-operative pulmonary hypertension. N=12(21.4%) required pre-operative intubation, 4(7.1%) requiring inhaled nitric oxide, n=7 (12.5%) had hemodynamic instability/cardiopulmonary resuscitation (CPR). Surgical correction (supracardiac and infracardiac) was by conventional repair in 20 patients and sutureless in 15 patients. When comparing sutureless and conventional TAPVD repair techniques, no statistically significant differences were observed in rates of pulmonary hypertension crisis, hospital stay duration, non-invasive ventilation (NIV) duration, postoperative infections, or chest re-exploration rates. Similarly, the incidence of pulmonary venous obstruction (PVO) and early mortality was comparable between the two groups. The predictors of early mortality were seen in patients with pre-operative pulmonary hypertension (OR 5.63, p=0.048), pre-operative intubation (OR 9.29, p=0.008) and pre-operative CPR (OR 36.67, p=<0.001). Incidence of post-operative LCOS was strongly associated with pre-operative pulmonary hypertension (OR 3.90, p=0.02) while predictors of post-operative ECMO predominant in pati