Partial Anomalous Pulmonary Venous Return (PAPVR)
The four pulmonary veins return oxygen-rich blood from the lungs to the left atrium. From there, blood flows through the left ventricle to the aorta, where it is pumped to the rest of the body.
In partial anomalous pulmonary venous return (PAPVR), one or two of the pulmonary veins returns blood to the right atrium instead of the left atrium. This causes oxygen-rich blood to flow back to the lungs instead of on to the rest of the body.
Many children with PAPVR also have an Atrial Septal Defect (ASD).
Concerns and Symptoms
Because some oxygen-rich blood is continually flowing between the lungs and the right atrium, the right chambers of the heart may become dilated. Over time, the child may then develop an abnormal heart rhythm, also known as an arrhythmia. In addition, too much blood flow to the lungs may increase the pressure in the lung's blood vessels, leading to a condition called pulmonary hypertension.
If only one of the pulmonary veins is affected by the disorder, the child may not have any symptoms. If two of the veins are affected, the child may show shortness of breath during heavy exercise.
The operation to repair PAPVR is performed under general anesthesia, which means the child will be asleep during surgery.
First the surgeon makes a vertical incision in the front of the chest, opens the breastbone and exposes the heart. Blood from the heart is redirected to a bypass machine. The bypass machine does the job of the heart and lungs during the operation.
The surgeon then opens the heart. If the child has an ASD, the surgeon will create a type of patch that closes the defect and also redirects blood from the anomalous pulmonary vein to the left atrium.
If the child does not have an atrial septal defect, the surgeon simply redirects blood flow from the anomalous pulmonary vein to the left atrium.
After the defects are repaired, the surgeon shuts down the heart-lung bypass machine, and the heart starts beating again. The surgeon then closes the breastbone and chest incision and applies bandages to the incision site.