Cardiac CT by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9789811553059
Publisher: Springer Singapore

15.1.4 Management

The patient underwent complete APVC correction plus repair of atrial septal defect surgery.

15.2 Discussion

Abnormal connection between a pulmonary vein and systemic vein will result in volume overload of the right heart, with a physiological effect similar to that of an ASD. All or part of the blood from the systemic venous and pulmonary circulation flows into the right atrium, forming mixed blood. Most of the blood enters the pulmonary circulation through the pulmonary artery, leading to increased blood flow in the pulmonary circulation, which is easy to form pulmonary hypertension. A portion of the blood enters the left heart through the patent foramen ovale or ventricular septal defect, and then enters the systemic circulation. Because it is mixed blood, blood oxygen content is low which causes cyanosis.

Clinical symptoms mainly depend on the presence of pulmonary vein obstruction and the size of atrioventricular channel. Due to the stenosis of the pulmonary vein, the pulmonary vascular resistance increased, and left-to-right shunt will increase the pulmonary blood flow, leading to pulmonary hypertension, causing hypoxia and heart failure symptoms. For the surgeon, the main concerns are the presence of obstruction on the pulmonary venous and the location of abnormal connection of pulmonary venous (especially the relationship between the pulmonary venous confluence and the location of the left atrium), which are critical for the selection of surgical methods.

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