Obstructive Infracardiac TAPVR with Atypical Presentation

¹Paediatrics, Fellow Neonatology, Ravi Children's Hospital, Nellore, India

²HOD and Professor, Department of Neonatalogy and Paediatrics, Ravi Children's Hospital, Nellore, India

³Assistant Professor, Malla Reddy Medical College for Women, India

*Corresponding author: Dr. Christina Karthaka, Assistant Professor, Malla Reddy Medical College for Women, India, Phone: 9880788767, E-mail: [email protected]

Received Date: March 13, 2025

Published Date: June 13, 2025

Citation: Mallela J, et al. (2025). Obstructive Infracardiac TAPVR with Atypical Presentation. Neonatal. 6(1):24.

Copyrights: Mallela J, et al. © (2025).

ABSTRACT

Back Ground: Anamalous pulmonary venous return is one of the cardiac cause of respiratory distress in newborn and infants which is very rare and can present as early as few hours of birth till few months of age depending on type and degree of venous obstruction. It is one of the important congenital heart disease with varied clinical presentation. Newborn with obstructive TAPVR usually requires urgent intervention regardless of degree of obstruction. Surgical intervention may range from only relieving of obstruction by stenting or surgical procedure till repair and restoration of anatomical continuity between pulmonary veins and left atrium. Infracardiac TAPVC can drain into IVC or hepatic vein which is easy to access for surgery or it can drain into portal venous system which is difficult for the access. Case Presentation: A 2kg preterm (33 weeks) newborn presented to us with respiratory distress, hypoxia without cyanosis at 6 hours of life. Unsteroided mother with chest xray showed reticular shadowing. Echocardiography showed obstructed TAPVC draining into IVC.CT angiography demonstrated infracardiac TAPVC with a vertical vein going downward with an infradiaphragmatic path and stenotic lowest segment of it draining into IVC. Baby underwent an uneventful surgical repair. Conclusion: Present case highlights that diagnosis of TAPVR can be delayed or missed depending on severity of obstruction and high index of suspicion is always necessary. Also it adds that CT angiography helps in delineating cardiovascular anatomy and helps in performing palliative endovascular procedure in emergency basis where restoration of anatomical continuity between pulmonary veins and left atrium is not possible immediately.

Keywords: Anomalous Pulmonary Venous, Echocardiography, Pathophysiology, Lungs