Total Anomalous Pulmonary Venous Return (TAPVR)

Total anomalous pulmonary venous return (TAPVR) happens when veins (blood vessels) that bring blood from your baby’s lungs connect to the wrong place in their heart. As a result, their heart can’t put enough oxygen into the blood it sends to the rest of their body. TAPVR is a life-threatening heart condition. It’s congenital, which means it’s present at birth.

Some of the time, babies with total anomalous pulmonary venous return have trouble breathing soon after birth. Their skin may appear blue (or gray on darker skin).

All children with TAPVR also have an atrial septal defect (ASD). An ASD is a hole between your heart’s right and left atria.

Babies who have TAPVR need an operation. With early surgery, most children with TAPVR survive into adulthood. But some will need repeat surgery or procedures to treat narrowing in their veins later in life. Because of this, people with TAPVR need to see a cardiologist (a heart expert) regularly to monitor their health following surgery.

You may hear a provider call this condition total anomalous pulmonary venous connection (TAPVC).

TAPVR types

TAPVR types differ by how blood reaches the wrong place — your baby’s right atrium. Typically, your lungs send oxygen-rich blood to your heart’s left atrium (the chamber in your heart’s upper left side). In babies with TAPVR, the oxygen-rich blood flows through pulmonary veins to their heart’s right atrium instead.

In the right atrium, the oxygen-rich blood mixes with blood that doesn’t have as much oxygen. This low-oxygen blood travels out of the heart to the rest of your baby’s body.

The TAPVR types are:

Supracardiac TAPVR: Blood flows via an ascending vertical vein into the brachiocephalic vein and then through their superior vena cava (a large vein in their body).
Cardiac TAPVR: Blood moves through their coronary sinus. This vein normally drains blood that contains low levels of oxygen.
Infracardiac TAPVR: The connecting vertical vein comes from their liver and inferior vena cava.
Mixed TAPVR: A combination of veins from your baby’s lungs drain to more than one of the types mentioned above. This is the rarest form and the most difficult one to repair successfully.

How common is total anomalous pulmonary venous return?

Total anomalous pulmonary venous return is a rare condition. It affects 1 in about 7,500 newborns in the U.S. each year.

Symptoms

When to see a doctor

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Complications

Blood clots are a dangerous complication of atrial fibrillation (AFib). Blood clots can lead to stroke.

The risk of stroke from AFib increases as you grow older. Other health conditions also may increase the risk of a stroke due to AFib. These conditions include:

High blood pressure.
Diabetes.
Heart failure.
Some types of heart valve disease.

Blood thinners are commonly prescribed to prevent blood clots and strokes in people with atrial fibrillation.

Prevention

Healthy lifestyle choices can reduce the risk of heart disease and may prevent atrial fibrillation (AFib). Here are some basic heart-healthy tips:

Control high blood pressure, high cholesterol and diabetes.
Don't smoke or use tobacco.
Eat a diet that's low in salt and saturated fat.
Exercise at least 30 minutes a day on most days of the week unless your health care team says not to.
Get good sleep. Adults should aim for 7 to 9 hours daily.
Maintain a healthy weight.
Reduce and manage stress.

By Freedmans Health Clinic Staff

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