There was a prominent venous pattern over the heart and considerable irregularities of myocardial color.
After opening the pleura, large tortuous venous vessels as thick as a finger were seen.
Three with totally anomalous pulmonary venous connection had respiratory failure secondary to pulmonary edema and underwent successful correction following 1-4 days ofsupport.
The enterohepatic circulation is disrupted, with systemic shunting of the portal venous blood.
The venous connections, atrial chambers, great arteries and segmental connections were normal.
A theoretical advantage is of creating something closer to laminar flow and thus less energy wasted in conveying systemic venous blood to pulmonary arteries.
Also, additional procedures, such as balloon dilatation of stenotic pulmonary arteries or occlusion of systemic-to-pulmonary or venous-to-left atrial channels can be performed if required.
Ventricular septal defects, patentcy of the arterial duct, anomalous pulmonary venous connection and stenosis of the pulmonary arteries were also reported.
