Healthy Heart FunctionIn a healthy heart, blood flows from the right ventricle to the lungs via pulmonary arteries, and then pulmonary veins bring oxygen rich blood back to the left atrium and eventually on to the rest of the body.
Vena Cava- the main vein that returns unoxygenated blood to the right atrium of the heart from the body. |
Total Anomalous Pulmonary Venous Return (TAPVR)
What is it?
Total Anomalous Pulmonary Venous Return (TAPVR) occurs when the four pulmonary veins bring oxygenated blood to a place other than the left atrium; typically, to the right atrium, or Vena Cava. It is often accompanied by an atrial septal defect (ASD), or a hole in the wall between the right and left atria. What causes it?
The cause for TAPVR is unknown. |
How does it effect the body?
Without blood being able to reach the left side of the heart, it is never pumped out to the rest of the body, but rather cycles back and forth from the right side of the heart to the lungs and back again. The ASD, or a patent foramen ovale therefore becomes imperative for the survival of the newborn, which will at least allow a mixture of oxygenated and unoxygenated blood to pass to the left side of the heart. Occasionally, the abnormal pulmonary vein is also narrow or obstructed, preventing adequate venous return, and causing blood to back up into the lungs, causing pulmonary congestion.
Without blood being able to reach the left side of the heart, it is never pumped out to the rest of the body, but rather cycles back and forth from the right side of the heart to the lungs and back again. The ASD, or a patent foramen ovale therefore becomes imperative for the survival of the newborn, which will at least allow a mixture of oxygenated and unoxygenated blood to pass to the left side of the heart. Occasionally, the abnormal pulmonary vein is also narrow or obstructed, preventing adequate venous return, and causing blood to back up into the lungs, causing pulmonary congestion.
How can I assess for it?
Symptoms in infants may depend on the extent of obstruction of the pulmonary vein, as well as the size of the ASD. If the infant has an accompanying ASD, symptoms will typically be less severe as oxygenated and deoxygenated blood are able to mix. Infants may exhibit any of the following symptoms:
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How is it treated?
TAPVR requires surgery for correction. If obstruction of the pulmonary vein is severe enough, the infant may require emergency surgery immediately following delivery, although other infants with this diagnosis may not have the surgery for days or weeks after their birth. Surgery to correct this defect includes connecting the pulmonary veins back to the left ventricle, and placing a patch over the ASD.
TAPVR requires surgery for correction. If obstruction of the pulmonary vein is severe enough, the infant may require emergency surgery immediately following delivery, although other infants with this diagnosis may not have the surgery for days or weeks after their birth. Surgery to correct this defect includes connecting the pulmonary veins back to the left ventricle, and placing a patch over the ASD.