title: [Total abnormal pulmonary venous return. Preoperative stabilization by extracorporeal veno-venous circulation].
abstract: BACKGROUND
  Total anomalous pulmonary venous return (TAPVR) is a rare congenital cardiac disease. When this includes pulmonary artery hypertension, the infant is severely ill. Survival beyond infancy is rare without surgical correction.
  
  
  METHODS
  A girl in whom hydramnios and a short femur were discovered by ultrasonography at the 25th week of gestation was admitted to the intensive care unit a few hours after birth because of respiratory distress. Blood PaO2 was 37 mmHg, PaCO2, 36 mmHg, and pH 7.25. She had tachycardia (190/min) and circulatory insufficiency. Echocardiography showed right ventricular overload, a right-to-left shunt through a patent ductus arteriosus and foramen ovale and tricuspid insufficiency. This refractory hypoxemia was not corrected by conventional respiratory support, high-frequency oscillation plus dobutamine and dopamine followed by noradrenaline infusion. Because of further deterioration, the baby was given extracorporeal lung support; this rapidly improved the respiratory and hemodynamic conditions. Persistent pulmonary artery hypertension led to a second investigation that showed TAPVR She underwent emergency surgery.
  
  
  CONCLUSIONS
  Extracorporeal lung support can stabilize a precarious state in a case of severe congenital cardiac disease, so allowing surgical treatment under satisfactory conditions.
authors.affiliation: Service de Réanimation Pédiatrique Polyvalente, Hôpital Robert-Debré, Paris.
authors.forename: I
authors.initials: I
authors.lastname: Casadevall
authors.forename: J F
authors.initials: JF
authors.lastname: Germain
authors.forename: V
authors.initials: V
authors.lastname: Kazandjian
authors.forename: A
authors.initials: A
authors.lastname: Casasoprana
authors.forename: L
authors.initials: L
authors.lastname: Desplanques
authors.forename: F
authors.initials: F
authors.lastname: Laborde
authors.forename: A
authors.initials: A
authors.lastname: Azancot
authors.forename: I
authors.initials: I
authors.lastname: Maury
authors.forename: F
authors.initials: F
authors.lastname: Beaufils
mesh_terms: D004630:Emergencies; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000601:surgery*; D011300:Preoperative Care; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000601:surgery
vernacular_title: Retour veineux pulmonaire anormal total. Stabilisation préopératoire par circulation extra-corporelle veino-veineuse.