A clue to the diagnosis of TAPVD

Abstract

Total anomalous pulmonary venous drainage (TAPVD) is a rare form of congenital heart disease where all four pulmonary veins drain to the systemic venous circulation. A term infant was found to have low oxygen saturations on the neonatal check and he was admitted to the neonatal intensive care unit. An increasing oxygen requirement necessitated invasive ventilation. A blood gas taken from the umbilical venous catheter (UVC) showed a pO(2) of 28.1kPa - a finding that at the time was considered to be erroneous. An x-ray showed the UVC tip was located in the liver. The following day the baby was transferred to a cardiology centre where a diagnosis of unobstructed infracardiac TAPVD was made on echocardiography. In retrospect the unusually oxygenated venous gas was consistent with pulmonary venous return draining directly to the hepatic venous system. This could have provided a vital clue to diagnosis in a situation where an echocardiogram was not available.

COVID-19 in a Three-Year-Old Girl With Total Anomalous Pulmonary Venous Return: A Case Report

“…Preventive measures in the wake of infection have resulted in a reported decrease in ED visits by up to 50% in some institutes [ 1 ]. Many CHD correction surgeries have been delayed during the beginning of the pandemic as medical personnel were still in the midst of exploring the virus [ 1 - 2 ]. Regardless, healthcare workers are in need to reach this group of individuals in order to make sure follow up is properly done [ 1 ].…”

“…Regardless, healthcare workers are in need to reach this group of individuals in order to make sure follow up is properly done [ 1 ]. Total anomalous pulmonary venous return (TAPVR) is characterized by having all four pulmonary veins drain into the systemic venous circulation [ 2 ]. It is often accompanied by other congenital anomalies, such as patent foramen ovale (PFO) [ 3 ].…”

When pneumonia does not respond to antibiotics: a challenging neonatal diagnosis

“…A blood gas taken from an umbilical venous catheter (UVC) may appear erroneously saturated (but should not be dismissed) and may be a subtle clue to the presence of infracardiac TAPVC. 28 As a rightward QRS axis is the norm in early neonatal life, a 12-lead ECG provides little useful supplementary information ( box 5 ).…”