TITLE:
Complex TAPVC-Experience with Six Patients
AUTHORS:
Baskar Ranjith Karthekeyan, Periyasamy Thangavelu, Jebaraj Rethinasamy, Mahesh Vakamudi, Siva Muthukumar, Rajeshkumar Kodali, Kamalakannan Sambandham, Sushma Nandipati
KEYWORDS:
Total Anomalous; AV Canal; Complex; Congenital; Pulmonary Vein
JOURNAL NAME:
Surgical Science,
Vol.4 No.11,
November
26,
2013
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.