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TAPVC – Infracardiac Type

🫀 TAPVC – Infracardiac Type | 2D Echo Exploration Infracardiac TAPVC is a rare, cyanotic congenital heart defect where all pulmonary veins drain below the diaphragm into the systemic venous circulation, rather than into the left atrium. This is the most commonly obstructed form of TAPVC, leading to critical illness in neonates. 🔍 What is Infracardiac TAPVC? Pulmonary veins → form a posterior venous confluence Confluence drains inferiorly through a descending vertical vein Joins the portal vein, ductus venosus, hepatic veins, or inferior vena cava (IVC) Blood returns to the right atrium, bypassing the left atrium Systemic output depends on ASD or PFO 📹 2D Echo Features: Right atrial and right ventricular enlargement Small left atrium with no visible pulmonary venous connections Dilated vertical vein draining into the intra-abdominal venous system Color Doppler shows reverse or turbulent flow in hepatic veins (if obstructed) ASD/PFO with right-to-left or bidirectional shunt Subcostal sagittal view – key for visualizing descending vertical vein Suprasternal and apical views may be limited ⚠️ Common Echo Clue: Pulmonary venous confluence is located below the diaphragm, often seen with Doppler aliasing or venous congestion in hepatic veins 🧠 Clinical Features: Severe cyanosis and respiratory distress in early neonatal period Often presents with pulmonary edema, metabolic acidosis, and shock Obstruction is common due to compression of the descending vertical vein as it passes through the diaphragm or liver 💉 Treatment: Emergency surgery required Anastomosis of pulmonary venous confluence to left atrium ASD closure Relief of obstruction Requires preoperative stabilization and ventilatory support 🔬 Differential Diagnosis: Severe pulmonary hypertension Other obstructed TAPVC types Pulmonary venous stenosis Obstructed left heart lesions 📎 Hashtags: #EchoDxHub #InfracardiacTAPVC #TAPVC #2DEcho #CongenitalHeartDisease #PulmonaryVenousAnomaly #ASD #PediatricEcho #NeonatalCardiology #VerticalVein #DilatedHepaticVein #EchoEducation #CyanoticCHD #CardiacUltrasound