2673 (Title changed. Email Old: TOTAL ANOMALOUS PULMONARY VENOUS RETURN: CHINICAL ANALYSIS OF 27 CASES )

SIGNIFICANCE OF PULMONARY VENOUS OBSTRUCTION IN TOTAL ANOMALOUS PULMONARY VENOUS RETURN

Wang Pingyao¹, Hwang Betau², Lu Jenher², Tiu Chuimei², Weng Zengchung² and Meng Luara C. C.²

Department of Pediatric Cardiology Radiology and Cardiovascular Surgery, Veterans General Hospital, Chinese Taipei and School of Medicine National Yang-Ming University, Chinese Taipei

Background: Total anomalous pulmonary venous return (TAPVR) is a less common congenital cardiovascular anomaly but it has been detected more frequently these years due to the advent of echocardiography even though the cardiovascular magnetic resonance imaging.(MRI).

Object: The aim of this study was to analyze clinical manifestation and experience of TAPVR.

Materials and methods: During a 15-year period between Jan 1985 though Dec2000,a total of 27 cases with TAPVR were retrospectively enrolled. All of them had received 2-D and color Doppler echocardiography. Twenty-six of them received cardiac catheterization for diagnosis, and the other one only echocardio graphic diagnosis Of them, 21 had been operation and 3 had been autopsy to confirm the diagnosis In addition,10 had cardiovascular MRI examination for the accurate diagnosis, Data was analyzed by z-test and chi-square test for obstructed and non-obstructed TAPVR categories. Statistical significance was obtained if p<0.05.

Results: Among the 27 cases, 15(56%) were supracardiac type, 9(33%) intracardiac type, 2(7%) infracardiac type and only 1 (4%) was mixed type There was no sex different significance There were 20 cases with isolated TAPVR.7 in non-isolated. Pulmonary venous obstruction was noted in 11(55%) of isolated TAPVR and 4(57%) of non-isolated TAPVR Pulmonary hypertension was present in 17 of 23 cases who had received cardiac catheterization, 10 of them had pulmonary venous obstruction and 3 of them had systemic level of pulmonary pressure.23 patient received operation and 9 were died who were all expired before the one year-old Patients without operation three fourth were died (3/4).But there was no difference of surgical mortality between obstruction and non-obstruction group by age categories.

Conclusion: Although cardiac catheterization and angiocardiography is the gold standard for the diagnosis of most congenital heart disease, the 2-D and color Doppler Echocardiography has been provided the easy and accurate diagnotic image of TAPVR. Otherwise, the cardiac MRI has also provided the important supplement to detect TAPVR.