Pathophysiology, Investigations, and Management in Patients with Partial and Total Anomalous Pulmonary Venous Connection

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Published: 2022-03-17

Page: 59-72


Omar Elsaka *

Department of Cardiology, Faculty of Medicine, Mansoura University, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.

Moneer Ayman Noureldean

Department of Cardiology, Faculty of Medicine, Mansoura University, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.

Mohamed Adel Gamil

Department of Cardiology, Faculty of Medicine, Mansoura University, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.

Mostafa Tarek Ghazali

Department of Cardiology, Faculty of Medicine, Mansoura University, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.

Ashraf Hamada Abd Al-Razik

Department of Cardiology, Faculty of Medicine, Mansoura University, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.

Dalia Hisham

Department of Cardiology, Faculty of Medicine, Mansoura University, Mansoura Manchester Medical Program (MMMP), Mansoura, Egypt.

*Author to whom correspondence should be addressed.


Abstract

Background: The phrase "total and partial anomalous venous connection" describes a series of congenital cardiovascular anomalies in which one or even more pulmonary veins return to the right side of the heart or systemic venous circulation instead of emptying directly into the left atrium. Medical and surgical care necessitates a thorough understanding of the various anatomical subtypes, as well as physiological evaluation, clinical, and diagnostic evaluation. The anatomy, physiology, assessment, and treatment of whole or partial pulmonary venous connections, and the role of the inter - professional team in assessing and treating patients with this ailment, are all discussed in this exercise.

Conclusion: The objectives of this review paper are to recognise the underlying mechanisms of total and partial anomalous pulmonary venous connections, to explain the evaluation of total and partial anomalous pulmonary venous connections, to define the management approaches for partial anomalous pulmonary venous connections, and to sum up the most common complications associated with partial anomalous pulmonary venous connections.

Keywords: Congenital heart disease, genetics, genome, total anomalous pulmonary venous connection


How to Cite

Elsaka, Omar, Moneer Ayman Noureldean, Mohamed Adel Gamil, Mostafa Tarek Ghazali, Ashraf Hamada Abd Al-Razik, and Dalia Hisham. 2022. “Pathophysiology, Investigations, and Management in Patients With Partial and Total Anomalous Pulmonary Venous Connection”. Asian Journal of Research in Medicine and Medical Science 4 (1):59-72. https://www.jofmedical.com/index.php/AJRMMS/article/view/26.

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References

Al-Dairy A, Al-Kyakhi L, Al-Mithiab L, Al-Bitar L, Nabhani MF. Surgical repair of an isolated left-sided partial anomalous pulmonary venous connection in an 18-month-old child. Gen Thorac Cardiovasc Surg. 2021;69(1):103-106.

Al-Mutairi M, Aselan A, Al-Muhaya M, Abo-Haded H. Obstructed infracardiac total anomalous pulmonary venous connection: The challenge of palliative stenting for the stenotic vertical vein. Pediatr Investig. 2020;(2):141-4.

Arulselvam V, Kalis NN, Al Amer SR. Partial anomalous pulmonary venous connection with accessory pulmonary veins. Cardiovasc J Afr. 2018;29(2): e5-e7.

Behrendt DM, Aberdeen E, Waterson DJ, Bonham-Carter RE. Total anomalous pulmonary venous drainage in infants. I. Clinical and hemodynamic findings, methods, and results of operation in 37 cases. Circulation. 1972;46(2):347-56.

Cheung YF, Lun KS, Chau AK, Chiu CS. Fate of the unligated vertical vein after repair of supracardiac anomalous pulmonary venous connection. J Paediatr Child Health. 2005;41(7):361-4.

Chowdhury UK, Airan B, Malhotra A, et al. Mixed total anomalous pulmonary venous connection: anatomic variations, surgical approach, techniques, and results. J Thorac Cardiovasc Surg. 2008;135(1):106-16, 116.e1-5.

Craig JM, Darling RC, Rothney WB. Total pulmonary venous drainage into the right side of the heart; report of 17 autopsied cases not associated with other major cardiovascular anomalies. Lab Invest. 1957;6(1):44-64.

Douglas YL, Jongbloed MR, den Hartog WC, et al. Pulmonary vein and atrial wall pathology in human total anomalous pulmonary venous connection. Int J Cardiol. 2009;134(3):302-12.

Egbe A, Uppu S, Stroustrup A, Lee S, Ho D, Srivastava S. Incidences and sociodemographics of specific congenital heart diseases in the United States of America: an evaluation of hospital discharge diagnoses. Pediatr Cardiol. 2014;35(6):975-82.

Gao YA, Burrows PE, Benson LN, Rabinovitch M, Freedom RM. Scimitar syndrome in infancy. J Am Coll Cardiol. 1993;22(3):873-82.

Graham TP Jr, Jarmakani JM, Canent RV Jr. Left heart volume characteristics with a right ventricular volume overload. Total anomalous pulmonary venous connection and large atrial septal defect. Circulation. 1972;45(2):389-96.

Gutmark-Little I, Hor KN, Cnota J, Gottliebson WM, Backeljauw PF. Partial anomalous pulmonary venous return is common in Turner syndrome. J Pediatr Endocrinol Metab. 2012;25(5-6):435-40.

Han D, Pan S, Li H, Meng L, Luo Y, Ou-Yang C. Prognostic value of cardiac cycle efficiency in children undergoing cardiac surgery: a prospective observational study. Br J Anaesth. 2020;125(3):321-329.

Haworth SG. Total anomalous pulmonary venous return. Prenatal damage to pulmonary vascular bed and extrapulmonary veins. Br Heart J. 1982;48(6):513-24.

Hong YK, Park YW, Ryu SJ, et al. Efficacy of MRI in complicated congenital heart disease with visceral heterotaxy syndrome. J Comput Assist Tomogr. 2000;24(5):671-82.

Huhta JC, Gutgesell HP, Nihill MR. Cross sectional echocardiographic diagnosis of total anomalous pulmonary venous connection. Br Heart J. 1985;53(5):525-34.

Jacobs ML, Mavroudis C. Challenges of univentricular physiology in heterotaxy. World J Pediatr Congenit Heart Surg. 2011;2(2):258-63.

Jonas RA, Smolinsky A, Mayer JE, Castaneda AR. Obstructed pulmonary venous drainage with total anomalous pulmonary venous connection to the coronary sinus. Am J Cardiol. 1987; 59(5):431-5.

Kandathil A, Chamarthy M. Pulmonary vascular anatomy & anatomical variants. Cardiovasc Diagn Ther. 2018;8(3):201-207.

Kimball TR, Weiss RG, Meyer RA, Daniels SR, Ryckman FC, Schwartz DC. Color flow mapping to document normal pulmonary venous return in neonates with persistent pulmonary hypertension being considered for extracorporeal membrane oxygenation. J Pediatr. 1989;4(3):433-7.

Kirshbom PM, Flynn TB, Clancy RR, et al. Late neurodevelopmental outcome after repair of total anomalous pulmonary venous connection. J Thorac Cardiovasc Surg. 2005;129(5):1091-7.

Kobayashi D, Forbes TJ, Delius RE, Aggarwal S. Amplatzer vascular plug for transcatheter closure of persistent unligated vertical vein after repair of infracardiac total anomalous pulmonary venous connection. Catheter Cardiovasc Interv. 2012;80(2):192-8.

Kumar G, Chimoriya R, Awasthy N, Dagar KS. Vertical vein stenting as a therapeutic strategy for obstructed supracardiac total anomalous pulmonary venous connection. Ann Pediatr Cardiol. 2020;13(4):379-81.

Kyser JP, Bengur AR, Siwik ES. Preoperative palliation of newborn obstructed total anomalous pulmonary venous connection by endovascular stent placement. Catheter Cardiovasc Interv. 2006;67(3):473-6.

Lin SC, Teng RJ, Wang JK. Management of severe pulmonary hypertension in an infant with obstructed total anomalous pulmonary venous return using magnesium sulfate. Int J Cardiol. 1996; 56(2):131-5.

Mackie AS, Vatanpour S, Alton GY, et al. For the Western Canadian complex pediatric therapies program follow-up group. Clinical outcome score predicts adverse neurodevelopmental outcome after infant heart surgery. Ann Thorac Surg. 2015;99(6):2124-32.

Morin FC 3rd. Prostaglandin E1 opens the ductus venosus in the newborn lamb. Pediatr Res. 1987;21(3):225-8.

Mounir R, Nya F, Mohammed B, Ayad A, Bamous M. Adults forms of scimitar syndrome. J Card Surg. 2020;35(7):1697-1699.

Najm HK, Ahmad M, Salam Y, Klein J, Hasan SM, Majdalany D, Stewart RD, Pettersson G, Karamlou T. Early Outcomes for In situ pericardial roll repair for distant anomalous pulmonary venous return. Ann Thorac Surg. 2021;111(1):169-175.

Narula N, Wilson N, Kumar RS. Transcatheter closure of persistent unligated vertical vein after TAPVC surgery using the Amplatzer PDA device. Catheter Cardiovasc Interv. 2007;70(1):117-9.

Neill CA. Development of the pulmonary veins; with reference to the embryology of anomalies of pulmonary venous return. Pediatrics. 1956;18(6):880-7.

Norwood WI, Hougen TJ, Castaneda AR. Total anomalous pulmonary venous connection: surgical considerations. Cardiovasc Clin. 1981;11(2):353-64.

Ricci M, Elliott M, Cohen GA, et al. Management of pulmonary venous obstruction after correction of TAPVC: risk factors for adverse outcome. Eur J Cardiothorac Surg. 2003;24(1):28-36;discussion 36.

Rosales AM, Bolivar J, Burke RP, Chang AC. Adverse hemodynamic effects observed with inhaled nitric oxide after surgical repair of total anomalous pulmonary venous return. Pediatr Cardiol. 1999;20(3):224-6.

Sahn DJ, Allen HD, Lange LW, Goldberg SJ. Cross-sectional echocardiographic diagnosis of the sites of total anomalous pulmonary venous drainage. Circulation. 1979;60(6):1317-25.

Sano S, Brawn WJ, Mee RB. Total anomalous pulmonary venous drainage. J Thorac Cardiovasc Surg. 1989;97(6):886-92.

Seale AN, Uemura H, Webber SA, Partridge J, Roughton M, Ho SY, McCarthy KP, Jones S, Shaughnessy L, Sunnegardh J, Hanseus K, Berggren H, Johansson S, Rigby ML, Keeton BR, Daubeney PE. British congenital cardiac association. Total anomalous pulmonary venous connection: morphology and outcome from an international population-based study. Circulation. 2010;122(25):2718-26.

Shi G, Zhu Z, Chen J, et al. Total anomalous pulmonary venous connection: The current management strategies in a pediatric cohort of 768 patients. Circulation. 2017;135(1):48-58.

Smallhorn JF, Sutherland GR, Tommasini G, Hunter S, Anderson RH, Macartney FJ. Assessment of total anomalous pulmonary venous connection by two-dimensional echocardiography. Br Heart J. 1981;46(6):613-23.

Solymar L, Sabel KG, Zetterqvist P. Total anomalous pulmonary venous connection in siblings. Report on three families. Acta Paediatr Scand. 1987;76(1):124-7.

Tasaka H, Krug EL, Markwald RR. Origin of the pulmonary venous orifice in the mouse and its relation to the morphogenesis of the sinus venosus, extracardiac mesenchyme (spina vestibuli), and atrium. Anat Rec. 1996; 246(1):107-13.

Valsangiacomo ER, Hornberger LK, Barrea C, Smallhorn JF, Yoo SJ. Partial and total anomalous pulmonary venous connection in the fetus: two-dimensional and Doppler echocardiographic findings. Ultrasound Obstet Gynecol. 2003; 22(3):257-63.

van der Velde ME, Parness IA, Colan SD, et al. Two-dimensional echocardiography in the pre- and postoperative management of totally anomalous pulmonary venous connection. J Am Coll Cardiol. 1991; 18(7):1746-51.

Van Praagh S, Carrera ME, Sanders S, Mayer JE, Van Praagh R. Partial or total direct pulmonary venous drainage to right atrium due to malposition of septum primum. Anatomic and echocardiographic findings and surgical treatment: a study based on 36 cases. Chest. 1995; 107(6):1488-98.

Wang H, Kalfa D, Rosenbaum MS, Ginns JN, Lewis MJ, Glickstein JS, Bacha EA, Chai PJ. Scimitar Syndrome in Children and Adults: Natural History, Outcomes, and Risk Analysis. Ann Thorac Surg. 2018;105(2):592-598.

Ward KE, Mullins CE, Huhta JC, Nihill MR, McNamara DG, Cooley DA. Restrictive interatrial communication in total anomalous pulmonary venous connection. Am J Cardiol. 1986;57(13):1131-6.

Wilson AD, Rao PS, Aeschlimann S. Normal fetal foramen flap and transatrial Doppler velocity pattern. J Am Soc Echocardiogr. 1990;3(6):491-4.

Yap SH, Anania N, Alboliras ET, Lilien LD. Reversed differential cyanosis in the newborn: A clinical finding in the supracardiac total anomalous pulmonary venous connection. Pediatr Cardiol. 2009;30(3):359-62.