Systemic and Pulmonary Venous Connections Flashcards
TAPVR, PAPVR, Pulmonary vein stenosis, Left SVC
What is Partial anomalous pulmonary venous return, PAPVR
when one or more, but not all, of the pulmonary veins drain back to the RA
severity of symptoms will depend upon the number of the veins draining anomalously
What atrial septal defect can occur in conjuntion with PAPVR?
Sinus venosus ASD
Clinical signs of PAPVR
in many cases there are no significant symptoms
similar to a small ASD
PAPVR, the right upper PV is commonly found draining indirectly into the RA via
abnormal connection where the RUPV drains into the SVC and then into the RA
what are the characteristics of the RV due to PAPVR is
RV is often dilated and can become hypertrophic due to the volume overload
PAPVR surgical treatment
what to look for in postop
- usually does not require treatment if not symptomatic
- correct draingage to LA if needed
Post op confirm there is no PV obtrustion and ASD closed
IS TAPVR a cynotic defect? What make TAPVR more severe in some cases vs others?
**Yes **
If the pulmonary veins are obstructive and the ASD is restrictive there less oxygenated flow getting to the body. Therfore the baby is more sypmtomatic and cynotic than a baby with unobstructive Pulmonary veins and unrestrictive ASD.
What are the types of TAPVR?
surgical procedure shown in image
Supracardiac TAPVR: all four veins return to the RA above the diaphram. From the confluence there is a pulmonary vertical vein that connects to the SVC via a innominate vein.
Intracardiac TAPVR: the veins drain to a dilated coronary sinus and drains into the RA.
Infracardiac TAPVR: the four veins drain into a *confluence *behind the LA then decends to enter the IVC and then RA.
What must be present in order for mixing of the blood in TAPVR?
ASD or PFO
right to left shunting, for partially oxgenated blood to get to the left side
must have!
The vertical vein in TAPVR is a embryonic remnant of the?
Cardinal Vein
what normally drains into the coronary sinus?
Coronary veins of the myocardium empty into the sinus and into the RA
During Supracardiac TAPVR where does the mixing of oxygenated and deoxygenated blood take place?
SVC and RA
During Infracardiac TAPVR where does the mixing of oxygenated and deoxygenated blood take place?
IVC and RA
During Intracardiac TAPVR where does the mixing of oxygenated and deoxygenated blood take place?
coronary sinus and RA
Two dimensional Echo findings from TAPVR
- Right to Left atrial level shunting “necessary to survive”
- RVE
- smallish LA
- confluence posterior to LA
- Dilated coronary sinus whale tale (in apical/subcostal views)
- RAE
Whale tale is the Rt and Lt pulmonary veins dumping into the confluence
