Cardiac function in total anomalous pulmonary venous return before and after surgery

Cardiac performance was evaluated in 12 infants with isolated total anomalous pulmonary venous return. Four had significant pulmonary venous obstruction and severe pulmonary hypertension (group A). Eight had no obvious venous obstruction, and the pulmonary pressures were lower (group B). In all subj...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1977-02, Vol.55 (2), p.361-370
Main Authors: Mathew, R, Thilenius, O G, Replogle, R L, Arcilla, R A
Format: Article
Language:English
Subjects:
Angiocardiography
Cardiac Volume
Female
Follow-Up Studies
Heart Defects, Congenital - physiopathology
Heart Defects, Congenital - surgery
Heart Ventricles - physiopathology
Hemodynamics
Humans
Infant
Infant, Newborn
Male
Pulmonary Circulation
Pulmonary Veins - abnormalities
Pulmonary Veins - surgery
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Summary:Cardiac performance was evaluated in 12 infants with isolated total anomalous pulmonary venous return. Four had significant pulmonary venous obstruction and severe pulmonary hypertension (group A). Eight had no obvious venous obstruction, and the pulmonary pressures were lower (group B). In all subjects, right ventricular end-diastolic volume was increased (197% of predicted normal) and its ejection fraction was normal. Left ventricular volume was, generally speaking, still in the normal range (87% of predicted normal); however, its ejection fraction was reduced (0.57 vs normal of 0.73) and left ventricular output was low (3.08 L/min/m2 vs normal of 3.98). Left atrial volume was consistently small (53% of predicted normal) with an appendage of normal size. The infants in group A had smaller chamber volumes/m2 BSA than those in group B. Left atrial function was abnormal, characterized by reduced reservoir function and a greater role as "conduit" from right atrium to left ventricle. Left atrial size was not found to be critical in the surgical repair of TAPVR. Cardiac function is restored to normal following surgery.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.55.2.361