TAPVD

Total Anomalous Pulmonary Venous Drainage

TAPVD

The Pulmonary Veins, which carry blood back to the heart after it has circulated through the lungs, are not connected to the left atrium.Instead they are connected to one of the veins from the main circulation so that the blood returning from the lungs drains back to the right side of the heart.In the example illustrated here all the pulmonary veins are connected to the Superior Vena Cava (SVC).This is referred to as ‘Supracardiac TAPVD.

1. Signs like ASD (Continuous mur. In 25%)

2.  X-Ray  : Figure below (Snowman Appearance)

Infracardiac TAPVD

In this form of the defect the blood returning from the lungs returns through the Inferior Vena Cava and is often ‘obstructed’, leading to early onset of severe symptoms.

Signs and symptoms of TAPVD

Right ventricular heave
Loud S1
Fixed split S2
S3 gallop
Systolic ejection murmur at left upper sternal border
Cardiomegaly
Right axis deviation on ECG
Snowman sign or `figure of 8 configuration` on chest radiograph
Right ventricular hypertrophy
Cyanosis, Tachypnea, Dyspnea since the overloaded pulmonary circuit can cause pulmonary edema

Treatment for TAPVD

TAPVD Repair

In TAPVC without obstruction, surgical redirection can be performed within the first month of life. The operation is performed under general anesthesia. The four pulmonary veins are reconnected to the left atrium, and any associated heart defects such as atrial septal defect, ventricular septal defect, patent foramen ovale, and/or patent ductus arteriosus are surgically closed. With obstruction, surgery should be undertaken emergently. PGE1 should be given because a patent ductus arteriosus allows oxygenated blood to go from the circulation of the right heart to the systemic circulation.

Partial anomalous pulmonary venous connection

A Partial anomalous pulmonary venous connection (or Partial anomalous pulmonary venous drainage or Partial anomalous pulmonary venous return) is a congenital defect where the right atrium is the point of return for the blood from some (but not all) of the pulmonary veins.