Anomalous Pulmonary Venous Return

Treatment

Surgical repair is necessary for anomalous pulmonary venous return. During surgery, the pulmonary veins are reconnected to the heart’s left atrium, and the hole in the wall between the two atria is closed.



Surgical results are typically very good, and children typically lead normal lives after the defect is repaired, unless there’s been significant damage to the lungs due to obstruction of flow through the veins.



Occasionally after surgery, the pulmonary veins may become obstructed again at the point where they enter the left atrium. These factors may lead to high blood pressure in the lungs. This obstruction (and resulting high blood pressure) may be relieved through a catheterization procedure in which a doctor delivers a small wire mesh tube (stent) through the arteries and implants it at the entrance of the left atrium to help keep the pulmonary vein open. Alternatively, surgical re-repair of the obstructed veins may be performed.

Despite the use of stents, balloon angioplasty, or reoperation, the renarrowing of the pulmonary veins (restenosis) can be a significant problem. If there’s an abnormal tissue response that causes abnormal growth within the vessels, multiple angioplasty or stenting procedures may have to be performed. Another operation may be indicated as well.