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Normally, oxygenated blood flows from the lungs to the left atrium through the pulmonary veins. In a case of Total Anomalous Pulmonary Venous Return (TAPVR), the pulmonary veins drain into the right atrium rather than the left atrium. When this happens, the oxygenated blood returning from the lungs mixes with the deoxygenated blood in the right atrium.
Some form of communication between the right and left sides of the heart, usually an atrial septal defect (ASD), must be present in order for oxygenated blood to reach the body. Surgical repair of total anomalous pulmonary venous return is required within the first few months of life. The goal of corrective surgery is to surgically create a connection between the pulmonary veins and the left atrium.
How Total Anomalous Pulmonary Venous Return Differs From Normal Cardiac Anatomy?
If your child has total anomalous pulmonary venous return the structure of his or her heart is different from normal cardiac anatomy.
Heart With Normal Cardiac Anatomy
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When your child has a congenital heart defect, there's usually something wrong with the structure of his or her heart's structure.
The heart is composed of four chambers. The two upper chambers, known as atria, collect blood as it flows back to the heart. The two lower chambers, known as ventricles, pump blood with each heartbeat to the two main arteries (the pulmonary artery and the aorta). The septum is the wall that divides the heart into right and left sides. The atrial septum separates the right and left atria; likewise, the ventricular septum separates the two ventricles.
There are four valves that control the flow of blood through the heart. These flap-like structures allow blood to flow in only one direction. The tricuspid and mitral valves, also known as the atrioventricular valves, separate the upper and lower chambers of the heart. The aortic and pulmonary valves, also known as the arterial valves, separate the ventricles from the main arteries. Oxygen-depleted blood returns from the body and drains into the right atrium via the superior and inferior vena cavas. The blood in the right atrium then passes through the tricuspid valve and enters the right ventricle.
Next, the blood passes through the pulmonary valve, enters the pulmonary artery, and travels to the lungs where it is replenished with oxygen. The oxygen-rich blood returns to the heart via the pulmonary veins, draining into the left atrium. The blood in the left atrium passes through the bicuspid, or mitral, valve and enters the left ventricle.
Finally, the oxygen-rich blood flows through the aortic valve into the aorta and out to the rest of the body.
From Nemours' KidsHealth
- Cardiac Catheterization
- ECG (Electrocardiogram)
- A to Z: Hypoplastic Left Heart Syndrome
- If Your Child Has a Heart Defect
- Coarctation of the Aorta
- Heart Murmurs and Your Child
- A to Z: Tetralogy of Fallot
- Tetralogy of Fallot
- Patent Ductus Arteriosus (PDA)
- A to Z: Patent Ductus Arteriosus (PDA)
- Atrial Septal Defect
- Ventricular Septal Defect
- Heart and Circulatory System
- Congenital Heart Defects Special Needs Factsheet
- When Your Child Needs a Heart Transplant
- A to Z: Atrial Flutter
- Congenital Heart Defects
Trusted External Resources
A to Z: Patent Ductus Arteriosus (PDA)
A to Z: Patent Ductus Arteriosus (PDA)
May also be called: PDA
More to Know
The ductus arteriosus (DA) is a normal blood vessel that connects two major arteries — the aorta and the pulmonary artery — that carry blood away from the heart in a developing fetus. The DA diverts blood away from the lungs, sending it directly to the body. The lungs are not used while a fetus is in the amniotic fluid because the baby gets oxygen directly from the mother's placenta. When a newborn breathes and begins to use the lungs, the DA is no longer needed and usually closes during the first 2 days after birth.
If the DA fails to close, a patent (meaning "open") ductus arteriosus is the result. Oxygen-rich blood from the aorta mixes with oxygen-poor blood in the pulmonary artery, and too much blood flows into the lungs.
Babies with a PDA may have poor feeding, poor growth, difficulty breathing, excessive sweating, fatigue, or a bluish color to the skin. A larger PDA puts a strain on the heart and increases blood pressure in the pulmonary arteries. A smaller PDA may not cause any symptoms.
Keep in Mind
In the vast majority of babies who have a small PDA but otherwise normal heart, the PDA will shrink and go away on its own in the first few days of life. Other PDAs may close on their own within the first year of a baby's life.
Large PDAs are rare, but can strain the heart and cause other problems. Medications, catheter-based procedures, or surgery may be used to close these PDAs.
All A to Z dictionary entries are regularly reviewed by KidsHealth medical experts.
Date reviewed: September 26, 2016