Total Anomalous Pulmonary Venous Connection in a Teenage Patient

Total anomalous pulmonary venous connection is usually seen and treated in childhood or in neonatal period in his obstructive type. Sometime it can be detected beyond the first decade. The objective of this case report is to give prove of the fact that it can be seen and treated in a teenager. We present a rare case of 15 years old boy who was admitted for supraventricular tachycardia with hypotension. Emergency electrocardiography showed atrial Flutter with a frequency of 225 beats/min. He complained from dyspnea state 2 at New York Heart Association functional classification before. The echocardiography showed a dilated coronary sinus in cardiac-type total anomalous pulmonary venous connection associated with a large atrial septal defect. Cardiac rhythm was normal after administration of Amiodarone. In cardiopulmonary bypass, an incision was made from the atrial septal defect to unroof the coronary sinus; a large pericardial patch was put to close the unroofing coronary sinus and let it in the left atrium. A De Vega tricuspid annuloplasty was done to reduce the tricuspid valve leak. The patient’s postoperative course was uneventful and was discharged in day 9 after operation. Total pulmonary venous return can evolve until teenage if the atrial septal defect is large. Evolution is good after a complete repair.