Palliating Premature Infants With Obstructed Total Anomalous Pulmonary Venous Connection via Catheterization

Obstructed total anomalous pulmonary venous connection (TAPVC) involves anomalous drainage of all pulmonary veins to a location other than the left atrium and typically causes significant respiratory symptoms requiring urgent surgical repair. Premature infants born with obstructed TAPVC are often not considered to be suitable surgical candidates due to their size and therefore pose a significant treatment dilemma. Catheter-based interventions provide a temporizing option for infants with obstructed TAPVC, allowing for hemodynamic stabilization and growth until surgical intervention is feasible. We describe the course of two premature infants with obstructed TAPVC who were palliated with stenting of their anomalous pulmonary veins. Both infants required repeat catheter-based intervention for recurrent stenosis and ultimately underwent successful surgical repair at an acceptable weight and corrected gestational age. We propose that a novel catheter-based approach to initial management may be a beneficial option in the premature and low-weight patient population.