MORPHOLOGIC CHARACTERISTICS OF EIGHTY FOUR PATIENTS WITH TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION

ABSTRACT
Objective: We report the results of our retrospective cross sectional study from January 2014 through February 2017,
of the anatomic features of total anomalous pulmonary venous connection (TAPVC) and its associated cardiovascular
anomalies in pediatric patients.
Methodology: Computed tomography angiography (CTA) results of TAPVC were extracted from pediatric cardiology
clinic of Hayatabad Medical Complex, Peshawar from January 2014 to February 2017. The CTA is considered as the
gold standard for the diagnosis of total anomalous pulmonary venous drainage. All the CT angiograms were taken with
the help of Toshiba 64 aquiloin machine and reviewed by pediatric cardiologist. Overall, data was summerized using
tables and graphs. Differences in the characteristics of participants by types of TAPVC were analyzed using the chi
square test for categorical data. All statistical analyses were performed using SPSS version 22. Statistical significance
was defined as p<0.05.
Results: Total of 84 patients was included in the study. Age range was from 15 days (0.5 months) to 20 years (240
months) with a median of 4 months (Inter-quartile range 2 to 10 months). Males were 57 (67.9%) while females were
27 (32.1%). Types of TAPVC included; Supra cardiac 33 (39.3%), Cardiac 23 (27.4%), infra cardiac 16 (19.0%) and
mixed 12 (14.3%). Obstruction in pulmonary venous pathway was present in 19 (22.6%) patients. There was significant
association between obstruction and types of TAPVC (50% of infra-cardiac versus 4.3% of cardiac, p=0.010). Patent
ductus arteriosus was present in present in 26 (31.0 %). The percentage with type of TAPVC varied significantly by PDA
association (56% of infra-cardiac versus nil in mixed, p=0.015).
Conclusions: Supracardiac is the most common type of TAPVC followed by cardiac, infracardiac and mixed type.
There is slight male preponderance. Obstruction in pulmonary venous pathway is significantly higher in the infracardiac
type. The association of PDA with infracardiac type is also significant