Complex TAPVC-Experience with Six Patients

Abstract

Total anomalous pulmonary venous connection becomes a totally different subset when associated with complex congenital anomalies. The combination of two separate life-threatening congenital heart defects complicates the management of these patients. Six patients with total anomalous pulmonary venous connection associated with complex congenital heart disease were studied. There were 2 girls and 4 boys. Three of them were less than 5 kg in weight, and the other 3 were more than 5 kg in weight. Four patients had severe pulmonary arterial hypertension and 2 patients had pulmonary stenosis. Three patients had supracardiac type with a right vertical vein, one had drainage to the right atrium superior vena cava junction, one patient had supra cardiac type but split flow to both the superior vena cava and one patient had cardiac type. Three patients had double outlet right ventricle. Three patients had atrioventricular canal defect and 2 patients had preoperative pulmonary vein obstruction. All patients underwent rerouting of pulmonary veins. Concomitant procedures included intraventricular tunnel repair of ventricular septal defect and infundibular resection in double outlet right ventricle. Atrioventricular canal repair was done for Rastelli type A atrioventricular canal. Superior vena caval plasty, atrioventricular canal repair and pulmonary artery banding were done in unbalanced atrioventricular septal defect and large double outlet right ventricle. Intracardiac repair through transatrial approach was done for tetralogy of Fallot. Right ventricle-pulmonary artery conduit was done for truncus arteriosus. Single ventricle repair was done for corrected transposition of great arteries. There were 2 hospital deaths.