Common to all types of Total Anomalous Pulmonary Venous Connection (TAPVC) is an atrial septal defect (ASD). Because none of the pulmonary veins connect normally to the left side of the heart (and thus out to the body) blood is shunted from the right atrium across the atrial septal defect. The absence of an atrial septal defect in Total Anomalous Pulmonary Venous Connection (TAPVC)is not compatible with survival.

Signs And Symptoms Surgery in India

Patients with Total Anomalous Pulmonary Venous Connection (TAPVC) and obstructed pulmonary venous return are extremely ill soon after birth. These children are severely cyanotic. They also have respiratory distress, with rapid breathing, grunting and retractions of the rib cage muscles. Often such infants may be initially thought to have pneumonia or other respiratory diseases of the newborn, until an accurate cardiac diagnosis is made.

If obstruction to pulmonary venous return is not present, children with Total Anomalous Pulmonary Venous Connection (TAPVC)without obstructed pulmonary venous return may be asymptomatic. There may be mild to moderate rapid or labored breathing. There is often cyanosis, but it may be mild and difficult to detect.

Some children with this more common type of Total Anomalous Pulmonary Venous Connection (TAPVC)are first detected when a physician hears a heart murmur during a physical examination. It is not uncommon for these children to go undiagnosed for weeks to months.Wish to speak to us now? Send us a message and we will call you back –click here

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Diagnosis Surgery in India

The diagnosis of Total Anomalous Pulmonary Venous Connection (TAPVC)may be initially suspected when a physician hears a typical heart murmur and detects evidence of right ventricular overload.

Measurement of oxygen saturation may detect a low value, typically in the mid-to-high 80s in children without pulmonary vein obstruction. An electrocardiogram will reveal evidence of right atrial and right ventricular enlargement.

Chest X-ray : – It will show heart enlargement and will also demonstrate increased pulmonary artery blood flow. In newborns with Total Anomalous Pulmonary Venous Connection (TAPVC)and obstructed pulmonary venous return, chest x-ray may show evidence of pulmonary edema.

Echocardiogram : – The definitive diagnosis of Total Anomalous Pulmonary Venous Connection (TAPVC)is usually made by echocardiogram. This study will demonstrate the abnormal return of the pulmonary veins, in a supracardiac, cardiac or infracardiac pattern. Echocardiography also demonstrates enlargement of the right atrium and right ventricle and can assess the size of and flow across the atrial septal defect.

Cardiac catheterization is required on occasions to make a definite diagnosis of Total Anomalous Pulmonary Venous Return. Cardiac catheterization will define the abnormal return of all pulmonary veins and is particularly helpful in unusual patterns of mixed Total Anomalous Pulmonary Venous Connection (TAPVC)

Cardiac catheterization can also determine accurately whether or not pulmonary veins are obstructed and if the atrial septal defect is restrictive. If so, a balloon dilation procedure can be performed to enlarge the defect, in turn allowing better shunting of blood from the right to left atrium.

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Surgery in India

Total Anomalous Pulmonary Venous Connection (TAPVC) is a defect that requires surgical correction. The timing of the surgical repair varies depending on the type of Total Anomalous Pulmonary Venous Connection (TAPVC) present, and the condition of the child. Surgical repair is performed emergently in the newborn period for newborns with Total Anomalous Pulmonary Venous Connection (TAPVC)and obstructed pulmonary veins. This is typical for the intracardiac type. Some of these children will require extracorporeal life support (ECMO) prior to surgery because of their marked hemodynamic instability.

Children with Total Anomalous Pulmonary Venous Connection (TAPVC)without obstruction to pulmonary vein return typically undergo surgical repair electively days or weeks after the diagnosis is made.

In these children, although the surgery is not emergent, there is generally little benefit to be gained by waiting more than one or two months.

Rarely, Total Anomalous Pulmonary Venous Connection (TAPVC)is complicated by a restrictive atrial septal defect (i.e. a hole in the atrial septum that is not big enough to let sufficient blood through to the left side). In these children, a balloon dilation procedure may be performed at cardiac catheterization to improve the child’s condition before surgical repair.

In virtually all types of Total Anomalous Pulmonary Venous Return, the pulmonary veins return to a common confluence behind the left atrium. The surgical repair takes advantage of this fact. The common pulmonary vein confluence is connected by the surgeon to the back of the left atrium, resulting in a normal return of pulmonary veins to left atrial chamber.

All other routes for pulmonary venous drainage, such as the abnormal vessels that had carried pulmonary vein blood to the supra cardiac or intracardiac areas, are tied off. Finally, the atrial septal defect is also closed. This surgical repair therefore results in a normal circulation: the pulmonary veins returning normally to the left atrium, without abnormal returns or septal defects.