Explain Indications for Surgery of Total Anomalous pulmonary Venous Connection ?

Once TAPVC is diagnosed in a neonate with symptoms, operation should be undertaken immediately. It is one of the conditions which demand surgery in the first few days or weeks of life and usually before six months of age. There is no palliative measure except for atrial septostomy if in a rare case that is the only point of obstruction. Obstruction of the common pulmonary venous channel is more commonly in the infracardiac variety necessitating very early intervention. A few individuals without obstruction survive to childhood or adult life. The degree of cyanosis is not the main indication for surgery. There is good mixing in the right atrium and so cyanosis may be minimal. When pulmonary vascular disease id suspected cardiac catheterization and assessment of pulmonary vascular resistance is done with isoproterenol infusion. Otherwise surgery is undertaken after echocardiography.

In neonates when there is obstivction only at atrial septa1 defect, a balloon or blade septostomy is indicated. Definitive surgery is not delayed more than a few days after such a procedure.