The four pulmonary veins return oxygen-rich blood from the lungs to the left atrium.  From there, blood flows through the left ventricle to the aorta, where it is pumped to the rest of the body.

In Partial Anomalous Pulmonary Venous Return (PAPVR), one or two of the pulmonary veins return blood to the right atrium instead of the left atrium.  This causes oxygen-rich blood to flow back to the lungs instead of on to the rest of the body.

Many adults with PAPVR also have an atrial septal defect (ASD).

Concerns and Symptoms

Because some oxygen-rich blood is continually flowing between the lungs and the right atrium, the right chambers of the heart may become dilated.  Over time, this may cause an abnormal heart rhythm.  In addition, too much blood flow to the lungs may increase the pressure in the lungs blood vessels, leading to a condition called pulmonary hypertension.

If only one of the pulmonary veins is affected by the disorder, you may not have any symptoms.  If two of the veins are affected, you may experience shortness of breath during heavy exercise.

Treatment

The operation to repair PAPVR is performed under general anesthesia. 

First, the surgeon makes a vertical incision in the front of the chest, opens the breastbone, and exposes the heart.  Blood from the heart is redirected to a bypass machine.  The bypass machine does the job of the heart and lungs during the operation. 

The surgeon then opens the heart.  If you have an ASD, the surgeon will create a patch that closes the defect and also redirects blood from the anomalous pulmonary vein to the left atrium.

If you do not have an ASD, the surgeon simply redirects blood from the anomalous pulmonary vein to the left atrium.

After the defects are repaired, the surgeon shuts down the heart-lung bypass machine and the heart starts beating again.  The surgeon then closes the breastbone and chest incision, and applies bandages to the incision site.

Recovery

After surgery, you will be moved to the Intensive Care Unit (ICU).  There they will monitor your heart function and other vital signs.

Most patients remain in ICU for at least one night after surgery.  Once you are stable enough to leave the ICU, you will be moved to a regular hospital room.

You will remain in the hospital for several days after surgery.  The exact length of stay depends on the type of surgery and how well you are recovering.

Before being discharged, the staff will explain any medications to take.  These may include antibiotics to prevent infection while the heart heals, prior to dental work or any other procedure.  They will instruct you on any activity limitations or required follow-up care.