title: Cyanosis in a 9-month-old child after repair of total anomalous pulmonary venous return.
abstract: A 9-month-old girl presented with cyanosis after correction of total anomalous pulmonary venous return (TAPVR) to the coronary sinus in the neonatal period. During corrective surgery, the right superior vena cava (RSVC) was damaged and re-anastomosed to the right atrium. Echocardiography showed increased flow velocity in the pulmonary venous confluence. Therefore, pulmonary venous obstruction was suspected. However, subsequent cardiac MRI revealed a stenosed RSVC as well as a dilated left superior vena cava (LSVC) draining from the left innominate vein into the pulmonary venous confluence. The re-recruited LSVC drained deoxygenated blood into the systemic circulation, causing cyanosis. After uncomplicated placement of a stent in the narrowed RSVC and occlusion of the LSVC, transcutaneous saturations normalised immediately.
authors: Department of Paediatric Cardiology, Evelina Children's Hospital, Guys & St Thomas NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom. heiner.latus@googlemail.com
authors: Heiner
authors: H
authors: Latus
authors: Tarique
authors: T
authors: Hussain
authors: Thomas
authors: T
authors: Krasemann
authors: Gerald F
authors: GF
authors: Greil
mesh_terms: D003490:Cyanosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D011859:Radiography; D012587:Scimitar Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects*