PAPVR/TAPVR- Topic 13 Flashcards Preview

Congenital Defects & Pediatrics > PAPVR/TAPVR- Topic 13 > Flashcards

Flashcards in PAPVR/TAPVR- Topic 13 Deck (66)
Loading flashcards...
1

What are some of the variations that can occur in anamolous pulmonary venous return?

*Partially or entirely connected to RA
*Directly connected or connected via systemic venous return

2

What are some of the variations that can occur in anamolous pulmonary venous return?

*Partially or entirely connected to RA
*Directly connected or connected via systemic venous return

3

What is a better term for anamous venous return that "return" or "drainage"?

Anamolous connection

4

What are the two basic classifications of anamalous pulmonary venous connections?

1. TAPVC/TAPVR
2. PAPVC/ PAPVR

5

What are the two basic classifications of anamalous pulmonary venous connections?

1. TAPVC/TAPVR
2. PAPVC/ PAPVR

6

Describe abnormalities associated with TAPVC/TAPVR?

Serious physiologic abnormalities

7

Describe the abnormalities and symptoms associated with PAPVC/PAPVR?

Mild physiologic abnormality
Cab be asymptomatic

8

What is TAPVR?

oxygenated blood returns from the lungs back to the right atrium or a vein flowing into the RA not to the left side of the heart (2 entirely separate circulations)

9

Common Sympoms in TAPVR

Cyanosis
Pale, cool, clammy skin
Difficult/rapid breathing
Tachycardia
Poor appetite and insufficient weight gain (FTT)
Unusual tiredness or irritability

10

What is required for survival in TAPVR?

Large ASD or patent foramen ovale

11

What type of shunt is inherent in TAPVR?

Left to Right shunt (pulmonary veins to the right side)

12

What type of shunt is needed for survival in TAPVR?

Right to left shunt (via ASD/patent foramen)

13

Are the shunts in TAPVR cyanotic or acyanotic?

All are cyanotic

14

Compare the oxygenation in the four chamber in TAPVR?

Identical oxygenation in 4 chambers (w/ ASD)

15

TAPVR occurs due to abnormal development during the first ______ weeks of pregnancy, when the pulmonary veins are improperly connected

8

16

What are the 4 different types of TAPVR? How common are they?

Supracardiac (52%)
Intracardiac (30%)
Infracardiac (12%)
Mixed (6%)

17

What is the most common type of TAPVR?

Supracardiac

18

How do pulmonary veins drain in supracardiac TAPVR?

Vertical Vein --> Lt Brachiocephalic --> SVC

19

What do you see on the x-ray in supracardiac TAPVR?

Dilated SVC + Left verical vein (snowman heart)
Increased vasculature
Increased RV volume

20

What is the second most common type of TAPVR?

Intracardiac TAPVR

21

How do the pulmonary vein drain in intracardiac TAPVR?

Drains in to coronary sinus or RA
Increased pulmonary vasculature

22

What is overloaded in intracardiac TAPVR?

RV overload

23

What percent of I and II TAPVR survive to adults? (The rest die in the first year)?

20%

24

How do pulmonary veins drain in infracardiac TAPVR?

Long pulmonary veins course down the esophagus
Empty into portal vein or IVC
Veins constricted through the diaphram (obstruction)

25

What are some symptoms of infracardiac TAPVR?

Severe CHF (obstruction)
Associated with asplenia
Death in a few days

26

Asplenia

absence of normal spleen function

27

Asplenia

absence of normal spleen function

28

Mixed TAPVR

usually a mix of types I, II, and III

29

What is the severity of mixed TAPVR?

Can vary significantly; all encompassing mix of whatever does not fit in the other classes

30

Obstructive TAPVR: Severity

Severity depends on whether the pulmonary veins are obstructed