Total Anomalous Pulmonary Return

Abstract

Of 30 cases, 23 were verified at autopsy, 3 at surgery, and 4 additional cases are presumed to have this defect after thorough clinical evaluation. The anomalous vessels may drain into any one of several systemic or visceral veins, but the most common drainage pathways are into a "persistent left superior vena cava", the coronary sinus, or right atrium. Patients with this defect show a mild cyanosis and a left sternal border, nondiagnostic systolic murmur. X-ray study may demonstrate the "figure of eight" or "box-like" shape with increased pulmonary vascularity; angiocardiograms may reveal a typical pattern of events. The diagnosis is conclusive if the right atrial O2 saturation is equal to or higher than the peripheral arterial saturation. Three of 6 patients who submitted to surgery survived partial or totally corrective procedures.