• Journal of Chest Surgery
• /
• v.32 no.11
• /
• pp.1004-1008
• /
• 1999

Background: Total anomalous pulmonary venous return is a relatively rare disease which has a very high mortality(80% within a year) if not properly corrected surgically. Material and Method: Twenty-six infants with total anomalous pulmonary venous return underwent repair between May, 1991 and February, 1996. Result: There were 19 boys and 7 girls. The mean age at operation was 2.6 months(range: 5 day to 11 month) and the mean body weight was 4.3kg(range:2.8 to 6.7 kg). Preoperative stabilization included ventilator for 5 patients and inotropic support for 6 patients. There were 6 hospital mortalities. Significant risk factors of operative mortality were preoperative ventilator care(p<0.03) and preoperative inotropic support(p<0.05). Age, body weight at operation, pulmonary venous obstruction, high pulmonary arterial pressure, spurasystemic right ventricular pressure or emergency operation did not affected the operative outcome. Postperative pulmonary venous obstruction occurred in three patients 2 or 3 months later, among them one patient was reoperated. The actuarial survival was 76% at 40 months. Conclusion: Although early mortality was high, repair of total anomalous pulmonary venous return should be attempted in early life, but the patients receiving ventilator care or inotropic support need special attention.

• Journal of Chest Surgery
• /
• v.33 no.10
• /
• pp.827-829
• /
• 2000

We experienced a case of partial anomalous pulmonary venous return from righ lung to inferior vena cava, which combined with Scimitar sign in 18 years old female patient. Diagnostic procedures were simple chest x-ray chest CT, and cardiac catheterization. We redirected the anomalous venous flow from inferior vena cava to left atrium through the intracardiac tunnel which was made with autologous pericardium. Postoperative course was not eventful.

• Journal of Chest Surgery
• /
• v.28 no.2
• /
• pp.177-179
• /
• 1995

Sinus venosus type atrial septal defect is commonly associated with partial anomalous pulmonary venous return[PAPVR . Ideal surgical repair of sinus venosus ASD with PAPVR demands complete closure of septal defect with redirection of the anomalous pulmonary venous return to the left atrium without obstructing the superior vena cava[SVC or the anomalous pulmonary vein and without injury of sinoatrial node and residual shunt. In our two patients, the closure of sinus venosus ASD and correction of PAPVR could be accomplished by simple direct sutures without using a patch or flap. Both patients had a good outcome.

• Journal of Chest Surgery
• /
• v.27 no.1
• /
• pp.52-56
• /
• 1994

This is case report of total anomalous pulmonary venous return with atrial septal defect which were corrected surgically by intracardiac procedure under total cardiopulmonary bypass.Two patients were supracardiac type,cardiac and mixed type was each one.The mixed type was three years old female patient.She was diagnosed as atrial septal defect with partial anomalous pulmonary venous return[right pulmonary vein drains into superior vena cava and right atrium] and corrected as usual.After operation,she underwent exertional dyspnea and frequent tachycardia.Chest x-ray film showed pulmonary congestion.Follow up cardiac cineangiogram revealed that left pulmonary vein also anomalously drained into left innominate vein through vertical vein.Through left thoracotomy,anastomosis was successfully carried between left atrium and vertical vein without cardiopulmonary bypass and there was no sign of pulmonary artery obstruction for two years follow up.The other three patient were corrected successfully without complication and got good result.

• Journal of Chest Surgery
• /
• v.24 no.11
• /
• pp.1154-1159
• /
• 1991

Anomalous systemic venous return to the right atrium is clinically innocuous and cause no functional disturbances or physiologic abnormalities by themselves and consequently require no treatment but may be surgical importance. We experienced a case of adult TOF combined with anomalous systemic venous drainage. Rudimentary right SVC with draining left sided vertical vein and IVC with separately drained left vein was revealed at operation time. With the bicaval cannulation, large sucker was used for drainage of blood from the left hepatic vein. Postoperative angiocardiogram showed above findings and combined double inferior vena cava at lumbar level.

• Journal of Chest Surgery
• /
• v.29 no.3
• /
• pp.292-296
• /
• 1996

Total anomalous pulmonary venous return is a rare but serious cardiac malformation, accounting for only about 1.5~3% of congenital heart disease. Surgical results have been dramatically improved in the last two decades, largely owing to improved techniques of cardiopulmonary bypass and perloperative management. Seven patients ranging in age from 15 days to 11 years with total anomalous pulmonary venous return underwent repair between 1984 and 1995. The types of anomalous return were supracardiac in 5, and cardiac in 2. There were 5 boys and 2 girls. There were two hospital death, occurred in 15-day-old, and 40-day-old infants with supracardiac type. Follow-up periods have ranged from 3 months to 11 years, and all survivors have remained asymptomatic with normal growth and development.

• Journal of Chest Surgery
• /
• v.29 no.2
• /
• pp.213-218
• /
• 1996

Total anomalous pulmonary venous return (TAPVR) is very rare congenital heart disease. 25-year old male was admitted our hospital with dyspnea, headache and syncope as chief complaint. He was confirmed as mixed type TAPVR by echocardiography and cardiac catheterization. In this case, mixed type TAPVR was consisted with supracardiac type connection of left pulmonary vein and cardiac type of right pulmonary vein. Supracardiac type of left pulmonary common channel was anastomosed to the left auricular appendage during total cardiopulmonary bypass with fibrillating heart. Cardiac type of right pulmonary vein was operated during moderate hypothermia and aortic cross clamping. Coronary sinus septum was incised into ASD and closed with Gore-Tex patch so that right pulmonary blood flow directed to the left atrium. The patient's post-operative course was uneventful.

• The Korean Journal of Physiology
• /
• v.11 no.2
• /
• pp.17-22
• /
• 1977

By the intravenous infusion of saline solution through the postcaval vein, the effects of increasing the venous return on the heart rate were studied in the water turtle (Amyda japonica). The following results were obtained: 1) Prior to saline infusion, when the initial heart rate was below $50{\sim}55/min$ the heart rate was increased by the infusion. When the initial rate was above this value no changes in heart rate were observed following the infusion. 2) When the heart rate was decreased by vagal stimulation, the infusion elicited a remarkable increase in the heart rate. 3) Increased heart rate caused by tile infusion was not affected by vagotomy or sympathectomy. 4) These results suggest that the increase in heart rate secondary to increased venous return is under the control of a myogenic regulatory mechanism, not a neural mechanism.

• Journal of Chest Surgery
• /
• v.18 no.3
• /
• pp.440-445
• /
• 1985

Cor triatriatum is a variant of abnormal connection between the pulmonary vein and true left atrium, which is separated from accessory left atrium receiving pulmonary venous blood flow by fibromuscular diaphragm. Usually it is diagnosed after operation because difficulty in visualization of the diaphragm by conventional diagnostic tools. We experienced a rare entity of congenital heart disease diagnosed as car triatriatum with atrial septal defect and partial anomalous pulmonary venous return after completing operation, which was diagnosed as ASD with PAPVR preoperatively. Anomalous right pulmonary venous opening was located at right atrium, secundum type defect of atrial septum was present, and dual chambered left atrium without connection was also seen. Excision of the diaphragm and wide patch repair of ASD including right pulmonary vein were performed with good postoperative results. Herewith, we report this case with review of literatures.

• Journal of Chest Surgery
• /
• v.21 no.1
• /
• pp.148-151
• /
• 1988

We experienced 2 years and 5 months old male patient with partial anomalous pulmonary venous return of the left lung into the coronary sinus without atrial septal defect. After incising the atrial septum and the wall between the left atrium and the coronary sinus, we made the roof of the coronary sinus and closed the artificial atrial septal defect, with using patch, then we could change the direction of the blood flow from the coronary sinus into the left atrium. The patient was discharged on the 13th postoperative day after uneventful postoperative course.