What Is PAPVR Repair & What Are The Repair Complications?

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital heart defect of one or more pulmonary veins present from the time of birth.1

PAPVR Repair is a surgery performed under general anesthesia to redirect the blood to the correct veins with the help of a bypass machine.2

PAPVR is often associated with a sinus venous atrial septal defect and the late complications include patent ductus arteriosus not visualized at initial catheterization, breakdown of an oversewn atrial septal defect repair, and pulmonary venous obstruction.3,4

What Is PAPVR Repair?

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital heart defect of one or more pulmonary veins present from the time of birth. During this disorder, the pulmonary vein drains the blood into the right atrium instead of the left atrium resulting in a serious of complications. To fix this problem, your doctor usually often suggests PAPVR repair surgery, although not necessary.

Many but not all will require surgery because when the anomaly is found in only one vein, there are no major challenges however when both the veins drain the oxygenated red blood to the right side, it may result in enlargement or dilate resulting in heart failure or dysrhythmias which can be life-threatening.1

What Happens During PAPVR Repair Surgery?

Partial anomalous pulmonary venous return Repair is a surgery performed under general anesthesia to redirect the blood to the correct veins with the help of a bypass machine. The main purpose of the procedure is to re-route all the pulmonary venous return to the left atrium. During this procedure, the surgeon makes a vertical incision in the anterior of the heart, opens the breastbone, and exposes the heart. ASD is also fixed with a patch as part of the surgery.2

What Are PAPVR Repair Complications?

The PAPVR surgery depends on the obstruction when there is an excessive blood flow, surgery is often carried out on an urgent basis, however, in other cases, it is done during the first six months of life. Medical studies demonstrate that patients who have undergone this procedure showed excellent long-term results.

On the other hand, some possible complications were noticed after PAPVR surgery. The late complications include patent ductus arteriosus not envisioned at preliminary cardiac catheterization, failure of an over seamed atrial septal defect restoration, pulmonary venous blockade, and development of pulmonary artery hypertension later in adulthood.

These patients also showed an increased risk for subacute bacterial endocarditis (SBE). SBE is an infection triggered by bacteria in the plasma of the red blood cells. Children with cardiovascular diseases often experience this infection.

However, with the advancement in cardiovascular operations, these complications are successfully managed and help individuals lead a better quality of life. PAPVC repair can be performed efficiently with nominal side effects and later complications, especially the double patch technique has provided excellent reproducible outcomes.3,4

Anomalous pulmonary venous return (APVR) is an uncommon cardiovascular disease that occurs when the pulmonary veins flunk to develop normally. This often occurs at the time of birth. Pulmonary veins are blood vessels that transfer oxygenated blood from the lungs to the heart.

When the veins flunk there is an excessive flow of blood to the heart and there is no explicit way for the blood to get to the body. PAPVR repair surgery is often the most recommended option to treat this condition

References:

  1. University of Wisconsin Hospitals and Clinics Authority. “Partial Anomalous Pulmonary Venous Return (PAPVR).” UW Health, www.uwhealth.org/heart-cardiovascular/partial-anomalous-pulmonary-venous-return-papvr/10968.
  2. “Congenital Heart Disease in Adults.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 May 2020, www.mayoclinic.org/diseases-conditions/partial-anomalous-pulmonary-venous-return/cdc-20385691.
  3. Waqar, Tariq, et al. “Outcome after Surgical Repair of Partial Anomalous Pulmonary Venous Connection.” Pakistan Journal of Medical Sciences, Professional Medical Publications, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5216287/.
  4. Number 18-03: Lower Extremity Edema: Long Term Complication of PAPVR – Society for Cardiovascular Magnetic Resonance, scmr.org/page/COW1803/Number-18-03-Lower-extremity-edema-Long-term-complication-of-PAPVR.htm.

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