Abstract
Introduction. Total anomalous pulmonary venous connection (TAPVC) is a cyanotic congenital heart defect with severe hemodynamic disturbances, especially in the present of pulmonary venous flow obstruction. Prenatal diagnosis of TAPVC presents great difficulties, therefore comprehensive and prompt diagnosis of TAPVC after birth is crucial for successful surgical treatment.
Material and methods. The article presents the personal experience of treatment 30 patients (23 boys and 7 girls) with TAPVC from 1 day to 13 years old – Me (25%; 75%): 28.5 (14; 74) and body weight from 2.6 to 35 kg 3.7 (3.25; 4.8). All patients have been examined by routine computed tomography (CT) angiography. Based on the CT-scan, hemodynamic types and anatomical features were analyzed.
Results. The supracardiac type of TAPVC was identified in 14 (46.7%) patients, cardiac type – 8 (26.7%) patients, infracardiac – 6 (20%) patients and mix type – in 2 (6.6%) patients. The pulmonary venous flow obstruction was determined in 11 (36.6%) of all TAPVC patients. The routine use of CT-angiograhy provides a comprehensive assessment of anatomical aspects of pulmonary vein drainage in different types of TAPVC.
Conclusion. CT-angiography is a highly informative method, providing solution of the whole range of diagnostic tasks. The routine use of CT-angiography is advisable diagnostic tool, which gives an opportunity of preoperative surgical planning.
References
- Michielon G., Di Donato R.M., Pasquini L., Giannico S., Brancaccio G., Mazzera E. et al. Total anomalous pulmonary venous connection:long-term appraisal with evolving technical solutions. Eur. J. Cardiothorac. Surg. 2002; 22: 184–91. DOI: 10.1016/s1010-7940(02)00247-6
- Karamlou T., Gurofsky R., Al Sukhni E., Coles J.G., Williams W.G., Caldarone C.A. et al. Factors associated with mortality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation. 2007; 115: 1591–8. DOI: 10.1161/CIRCULATIONAHA.106.635441
- Dyer K.T., Hlavacek A.M., Meinel F.G.. De Cecco C.N., McQuiston A.D., Schoepf U.J. et al. Imaging in congenital pulmonary vein anomalies: the role of computed tomography. Pediatr. Radiol. 2014; 44 (9): 1158–68; quiz 1155–7. DOI: 10.1007/s00247-014-3044-7
- Darling R.C., Rothney W.B., Craig J.M. 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: 44–64.
- Vyas H.V., Greenberg S.B., Krishnamurthy R. MR imaging and CT evaluation of congenital pulmonary vein abnormalities in neonates and infants. Radiographics. 2012; 32 (1): 87–98. DOI: 10.1148/rg.321105764
- Seale A.N., Carvalho J.S., Gardiner H.M., Mellander M., Roughton M., Simpson J.et al. Total anomalous pulmonary venous connection: impact of prenatal diagnosis. Ultrasound Obstet. Gynecol. 2012; 40 (3): 310–8. DOI: 10.1002/uog.11093
- Laux D., Fermont L., Bajolle F., Boudjemline Y., Stirnemann J., Bonnet D. Prenatal diagnosis of isolated total anomalous pulmonary venous connection: a series of 10 cases. Ultrasound Obstet. Gynecol. 2013; 41 (3): 291–7. DOI: 10.1002/uog.11186
- Zhang Z., Zhang L., Xie F., Wang B., Sun Z., Kong S. et al. Echocardiographic diagnosis of anomalous pulmonary venous connections: Experience of 84 cases from 1 medical center. Medicine (Baltimore). 2016; 95 (44): e5389. DOI: 10.1097/MD.0000000000005389
- Shen Q., Pa M., Hu X., Wang J. Role of plain radiography and CT angiography in the evaluation of obstructed total anomalous pulmonary venous connection. Pediatr. Radiol. 2013; 43 (7): 827–35. DOI: 10.1007/s00247-012-2609-6
- Shi G., Zhu Z., Chen J., Ou Y., Hong H., Nie Z. et al. Total Anomalous Pulmonary Venous Connection: The Current Management Strategies in a Pediatric Cohort of 768 Patients. Circulation. 2017; 135 (1): 48–58. DOI: 10.1161/CIRCULATIONAHA.116.023889
- Seale A.N., Uemura H., Webber S.A., Partridge J., Roughton M., Ho S.Y. et al. Total anomalous pulmonary venous connection: morphology and outcome from an international population-based study. Circulation. 2010; 122: 2718–26. DOI: 10.1161/CIRCULATIONAHA.110.940825.
- Федорова Н.В., Любомудров В.Г., Мовсесян Р.Р., Михайлова Е.В., Цытко А.Л., Болсуновский В.А. и др. Опыт хирургического лечения тотального аномального дренажа легочных вен в детской городской больнице № 1 города СанктПетербург. Тезисы 18 съезда сердечно-сосудистых хирургов. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2012; 13 (6): 14. [Fedorova N.V., Lyubomudrov V.G., Movsesyan R.R., Mihajlova E.V., Cytko A.L., Bolsunovskij V.A. et al. Experience in surgical treatment of total abnormal drainage of pulmonary veins in children's city hospital # 1 in St. Petersburg. he Bulletin of Bakoulev Center for Cardiovascular Diseases. 2012; 13 (6): 14 (in Russ.)]
About the authors
- Ruben R. Movsesyan, Dr. Med. Sc., Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Cardiac Surgery of Children's City Hospital # 1, Professor, Department of Pediatrics and Pediatric Cardiology, Chief Pediatric Cardiac Surgeon of the Health Committee of Saint-Petersburg, orcid.org/0000-0003-3089-3113;
- Aleksandr A. Morozov, Cand. Med. Sc., Cardiovascular Surgeon, orcid.org/0000-0001-9350-8804;
- Mariya V. Golubeva, Head of Department, orcid.org/ 0000-0003-0123-9489;
- Natal’ya V. Fedorova, Cardiologist, orcid.org/0000-0002-0637-4201
