Prenatal diagnosis and antenatal history of total anomalous pulmonary venous return

Abstract

Objective: Total anomalous pulmonary venous return (TAPVR) is traditionally diagnosed by echocardiography or cardiac catheterization postnatally after the appearance of clinical signs. We report a case of TAPVR diagnosed prenatally by targeted echocardiography.

Case report: A 17-year-old woman was referred at 34 weeks of gestation because of persistent bradycardia. Echocardiography showed atrial disproportion and no direct pulmonary venous return to the left atrium. A female infant was delivered by cesarean section at 38 weeks of gestation. Echocardiography and cardiac catheterization were arranged soon after delivery and TAPVR was confirmed. The infant underwent surgical repair of TAPVR by anastomosis between the left atrium and pulmonary venous confluence as well as surgical ligation of the patent ductus arteriosus at the age of 2 days. The infant died on the 28th postoperative day due to obstruction of pulmonary venous return and respiratory failure.

Conclusion: With advances in sonographic equipment and careful evaluation of cardiac structures, it is possible to diagnose TAPVR prenatally. Pulmonary venous anatomy should be checked during prenatal examination.