Fetal TAPVR

Key Fetal Echo Features in Suspected TAPVR

• Obstruction to Pulmonary Venous Drainage
  → Use Doppler to assess for restricted pulmonary venous flow.
  → Obstruction may lead to rapid postnatal deterioration.
  
  

• Interatrial Communication (PFO/ASD)
  → Evaluate size and direction of atrial shunt.
  → Adequate right-to-left flow is critical; restriction signals high risk.
  
  

• Signs of Fetal Heart Failure / Hydrops Fetalis
  → Look for cardiomegaly, effusions, ascites, or edema.
  → Abnormal venous Dopplers (IVC, DV, umbilical vein) suggest elevated central venous pressure.
  
  

• Relative Chamber Sizes
  → Enlarged RA/RV and pulmonary arteries.
  → Small LA/LV and aorta; leftward septal shift.
  
  

• Associated Anomalies
  → Screen for CHD (e.g., heterotaxy, HLHS, TOF, DORV).
  → Assess for balanced ventricular sizes.
  
  

• Anomalous Pulmonary Venous Connection
  → Identify drainage site: supracardiac, cardiac, infracardiac, or mixed.
  
  

• Prenatal Diagnosis Importance
  → Enables perinatal planning and counseling.
  → Obstructive TAPVR requires immediate postnatal intervention.