ECHOCARDIOGRAPHIC SPECTRUM OF SUPRACARDIAC TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION

Although infracardiac total anomalous pulmonary venous connection (TAP VC) is almost always associated with venous obstruction, the incidence and location of obstruction in supracardiac TAPVC has not been comple tely delineated. This report summarizes our experience with 20 cases o f supracardiac TAPVC diagnosed by transthoracic echocardiography from Jan. 1989 to Mar. 1997. Fifty percent were obstructed, and five differ ent sites of narrowing were found. The most common sites of obstructio n were at the level of the left pulmonary artery (left vertical vein) and at the insertion into the superior vena cava (right vertical vein) . Because nonobstructed Doppler flow patterns are present proximal to the actual site of obstruction in the anomalous pathway, a thorough in terrogation of the entire venous channel with two-dimensional and Dopp ler echocardiography is essential to provide complete preoperative ana tomic and hemodynamic details to determine the nature and timing of su rgery in this condition.