Completely Abnormal Pulmonalvenenrückfluss (Tapvr)

In a completely abnormal pulmonary vein reflux, the pulmonary veins are not connected to the left atrium. Instead, the entire pulmonary vein reflux in the systemic venous circulation passes through one or more persistent embryological connections. If there is no obstacle for a Pulmonalvenenrückfluss, cyanosis turns out mild and the patients may have minimal symptoms. A severe obstruction of Pulmonalvenenrückflusses can occur, resulting in a severe neonatal cyanosis, pulmonary edema and pulmonary hypertension. The diagnosis is made by echocardiography. Surgical correction is required.

A completely abnormal Pulmonalvenenrückfluss (TAPVR- Fully abnormal Pulmonalvenenrückfluss.) Is responsible for 1-2% of congenital heart anomalies. The clinical manifestation depends on the connection between the Pulmonalvenen- Zusammmenfluss and the right side of the circuit. Among the most common species include the reflux

In a completely abnormal pulmonary vein reflux, the pulmonary veins are not connected to the left atrium. Instead, the entire pulmonary vein reflux in the systemic venous circulation passes through one or more persistent embryological connections. If there is no obstacle for a Pulmonalvenenrückfluss, cyanosis turns out mild and the patients may have minimal symptoms. A severe obstruction of Pulmonalvenenrückflusses can occur, resulting in a severe neonatal cyanosis, pulmonary edema and pulmonary hypertension. The diagnosis is made by echocardiography. Surgical correction is required. A completely abnormal Pulmonalvenenrückfluss (TAPVR- Fully abnormal Pulmonalvenenrückfluss.) Is responsible for 1-2% of congenital heart anomalies. The clinical manifestation depends on the connection between the Pulmonalvenen- Zusammmenfluss and the right side of the circuit. Among the most common types of reflux an ascending left vertical vein, which drains into the innominate vein include (supra cardiac TAPVR) via a descending vein infradiaphragmatisch emptied in the portal circulation (infra cardiac TAPVR) under connection of the confluence (with the coronary sinus cardiac TAPVR) the infradiaphragmatische discharge is always hampered, resulting in dramatic pulmonary edema and cyanosis, which does not respond to additional O2. The other two types do not always have a disability and cause slight signs of heart failure and mild cyanosis in the first month of life. Completely abnormal Pulmonalvenenrückfluss. The pulmonary veins are not connected to the left atrium. Instead, the entire pulmonary backflow into the systemic venous circulation passes through different connections. Systemic blood flow depends on atrial right-left shunt. AO = aorta; IVC = inferior vena cava; LA = left atrium; LV = Left ventricle; PA = pulmonary artery; PV = pulmonary veins, RA = right atrium; RV = right ventricle; SVC = superior vena cava. Symptoms and complaints newborns with restricted Pulmonalvenenrückfluss have severe pulmonary hypertension, pulmonary edema and cyanosis. Physical examination usually shows a parasternales lifting and a single, loud second heart sound (S2) without significant Herzgeräsuch. If the Pulmonalvenenrückfluss is not accessible, are any symptoms of heart failure before and physical examination detects a hyperdiynamisches Präkordkum, a loud and split S2, and a systolic discharge sound of grade 2-3 / 6, audible at the left sternal border. A mitteldiastolisches trikuspidales discharge noise may be heard at the lower left sternal. Some infants with free suprakardialem or cardiac TAPVR may be asymptomatic. Diagnostic chest X-ray and ECG Echocardiography The diagnosis is confirmed by a chest x-ray absorption and echocardiography. A cardiac catheterization is rarely necessary. Occasionally, a cardiac MRI or CT angiography is performed in order to obtain a better picture of the anatomy of the Pulmonalvenenrückflusses. The chest X-ray shows a small heart and severe diffuse pulmonary edema when a Pulmonalvenenobstruktion exists, otherwise cardiomegaly shows with increased pulmonary vascular markings. The ECG can be found a right-side deviation of the axis of the heart, a right ventricular hypertrophy and, occasionally, an enlargement of the right atrium. Treatment Surgical correction Drug treatment of heart failure (eg. As with diuretics, digoxin, ACE inhibitors) before surgery newborns with an obstruction of the return infradiaphragmatischen requiring emergency surgery. In older infants, the heart failure should be treated, followed by surgical correction once the child is stabilized. The surgical correction is to provide a wide anastomosis between the pulmonary veins confluence and the rear wall of the left atrium as well as in a ligature of the vein, which relieves the opening into the systemic venous circulation. The operation is different for a return to the coronary sinus. Here, the coronary sinus is exposed to the left atrium and the opening to the right atrium. Endocarditis prophylaxis preoperatively recommended but is only required for the first 6 months after surgery, unless there is a residual defect in addition to a surgical patch or prosthetic material before.

Health Life Media Team

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