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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
- ECG (Electrocardiogram)
- Cardiac Catheterization
- When Your Child Needs a Heart Transplant
- If Your Child Has a Heart Defect
- Heart and Circulatory System
- Congenital Heart Defects Special Needs Factsheet
- Heart Murmurs
- Coarctation of the Aorta
- Congenital Heart Defects
- Atrial Septal Defect
- A to Z: Tetralogy of Fallot
- A to Z: Atrial Flutter
- Patent Ductus Arteriosus (PDA)
- Ventricular Septal Defect
- Tetralogy of Fallot
- A to Z: Patent Ductus Arteriosus (PDA)
- A to Z: Hypoplastic Left Heart Syndrome
Trusted External Resources
Congenital Heart Defects Special Needs Factsheet
What Teachers Should Know
Congenital heart defects develop in fetuses early in pregnancy, causing one abnormality or a combination of abnormalities in the structure of the heart. Some of the more common defects are:
- holes in the walls between the heart's chambers
- abnormal valves
- abnormalities in the blood vessels entering or leaving the heart
About 8 out of every 1,000 newborns have congenital heart defects, which can range from mild to severe. Some may cause serious symptoms at birth, requiring intensive hospital care. Other defects may go undiagnosed until the teen or even adult years.
Most kids and teens with simple heart defects don't require any special care at school. Those with more complicated heart defects, however, may show signs that require attention, such as:
- rapid breathing or shortness of breath
- bluish coloring of the skin (cyanosis)
- chest discomfort
Students with congenital heart defects may:
- tire easily or want to avoid activities that require a lot of exertion
- have activity restrictions
- need to carry a water bottle to stay hydrated or stay indoors on hot days
- need extra time to go to and from classes
- need to go the bathroom a lot if they're taking diuretic medication
- have bluish skin coloring due to low oxygen levels
- need to use supplemental oxygen
- need to go to the school nurse for medications
- miss class time to see cardiologists or other medical professionals
- have developmental delays or learning problems
What Teachers Can Do
Check with your student's parents or guardians to learn about the nature of the heart condition and any effects on learning and school activities.
If a student with a congenital heart defect misses class time for doctor's visits or hospitalizations, allow extra time for assignments and provide make-up work if appropriate. Most kids and teens with congenital heart defects can fully participate in most physical and extracurricular activities and should be encouraged to do so.
Reviewed by: Mary L. Gavin, MD
Date reviewed: September 05, 2017