nitts2009
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I am very confused abt the shunting in TAPVR. Should it not be Right to left shut .
Kaplan Peds pg 135 talks abot a Left to Right shunt. How is that possible, if you are getting all the venous return to the right atrium .
Any help much appreciated!
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| nitts2009
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anybody.somebodyyyyyyyy??????????
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| nitts2009
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can anyone pleaseeeeeeeeee help me with this exaplanation...
desperately looking forward to any replies!
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| ngaybinhyen
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Let's start from fundamental concepts
In congenital heart disease
- Left side: chambers containing oxygenated blood (pulmonary veins, LA, LV, AO)
- Right side: non-oxygenated blood (SVC, IVC, RA, RV, pulmonary artery)
In TAPVR
- All pulmonary veins drain into RA ==> LEFT-TO-RIGHT shunting
- Now, there is no blood coming back to the LA directly from the pulmonary veins --> There MUST be an obligated RIGHT-TO-LEFT shunt at the atrial level for LV filling (for the child to survive)
Does it make sense?
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| nitts2009
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Thank You soo much ngaybinhyen. 
Yes it all make sense. Now when I think of it, I dont know why I even got confused in the first place ..
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| ngaybinhyen
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Now, clinically, the newborn will present with cyagnosis. I saw people sent the child to ECMO center overhere in the US. I mean even US neonatologists got confused sometimes and ofcourse cardiologist laughted at/with them.
And by the way, underdeveloped left heart may become an issue in the CVICU after surgery to reimplant/redirect PVs to LA.
This is an interesting malformation with lots of variations and mysteries
Thanks for the question
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| lampard
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tahnks ngaybihyen
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You have to win small battles ... to win war...!!!
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| ngaybinhyen
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