Total Anomalous Pulmonary Venous Return

Clinical:

* Symptoms depends on presence or absence of obstruction
* Obstructed: pulmonary edema within several days after birth
* Nonobstructed: asymptomatic at birth. CHF develops during first month

Hemodynamics:



Unobstructed Pulmonary Vein

* Causes a complete L-R shunt at atrial level.
* To sustain life, an obligatory R-L shunt must be present. Pulmonary flow is greatly increased leading to dilatation of RA, RV, PA.