Total anomalous pulmonary venous connection in the pediatric age: Importance of echocardiographic diagnosis and early repair

Objective. We studied patients who underwent surgical repair for total anom alous pulmonary venous return at our hospital. We report the importance of diagnosis by echocardiographic imaging before surgical treatment. Methods. Within the period of 1990-1999, fourteen patients underwent surgic al repair of this cardiopathy in our hospital. The type of anomalous draina ge was supracardiac in 6 patients, infracardiac in 4, to the coronary sinus in 1, and mixed-type in 3 patients. Eleven cases were diagnosed with an ec ho-Doppler study, the findings being confirmed intraoperatively. Results. There were 2 early deaths: one occurred in the operating room in a patient with a small left ventricle, and the second one was 35 days postop eratively as a result of a septic complication. Early in the postoperative period our primary goal has steadily been the control and treatment of pulm onary hypertension. After a mean follow-up time of 50 months, only 1 patien t needed to be reoperated on and the remainder are symptomless. Conclusions. That sufficient diagnostic data on total anomalous pulmonary v enous return can reliably be obtained by ultrasound scanning so that surger y can be promptly undertaken, and that its surgical risk is currently low a nd mid-term post-repair outcome is fairly good.