Expecting mother holding her belly while talking with doctor during ultrasound.

Total Anomalous Pulmonary Venous Return (TAPVR)

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When your baby is born with veins connecting to the wrong place in their heart, surgery is a must — and that can be a lot to take in.

The good news is that total anomalous pulmonary venous return (TAPVR) — also called total anomalous pulmonary venous connection (TAPVC) — can be repaired when it’s diagnosed early.

Cleveland Clinic Children’s expert pediatric cardiologists and surgeons frequently treat serious, rare congenital heart conditions like TAPVR. We’ll work quickly to confirm a diagnosis and treat your child as soon as possible. We offer expertise and compassionate support at every step.

Why Choose Cleveland Clinic Children's for TAPVR Care?

Personalized care:

We provide a lifetime of heart care for all ages. As your child becomes an adolescent, we’ll help them easily shift from our nationally recognized pediatrics heart care team to adult congenital heart care. Cleveland Clinic is the No. 1 hospital for heart care in the nation.

Caring approach:

Your family plays a big part in your baby’s medical care and well-being. That’s why we use a family-centered approach in all we do. Your child’s care team listens to your concerns, answers your questions and keeps you in the loop at each step — from diagnosis to recovery and beyond. Meet our team.

Innovation and research:

Cleveland Clinic Children’s never stops searching for the best ways to treat complex heart conditions in children. Our pediatric cardiovascular team uses advanced imaging techniques and technologies, like 3D print models, to make sure treatments are personalized to your child’s needs.

Virtual visits:

Not all appointments need to be in person. Our virtual visits are a great alternative for quick check-ins and follow-ups with your child’s provider. All you need is an internet connection and a smartphone, tablet or computer.

National recognition:

U.S. News & World Report consistently ranks Cleveland Clinic Children’s a top hospital in the nation. Newsweek has also named Cleveland Clinic a top hospital in the world.

Diagnosing TAPVR at Cleveland Clinic Children’s

If your child has total anomalous pulmonary venous return, it means the veins from their lungs connect to their heart in the wrong place. And it can affect how blood flows through their body to deliver oxygen to their organs. There are different types of TAPVR, based on where the veins incorrectly run to their heart. This serious heart condition happens before birth during fetal development.

In most cases, we can diagnose TAPVR before birth during a prenatal ultrasound. If we suspect TAPVR, we typically do a fetal echocardiogram, which can show the structure of your baby’s heart and confirm that they have the condition.

If your baby’s born with TAPVR, they’ll most likely be very sick with significant symptoms right after birth. Symptoms include:

Bluish or greyish skin (cyanosis).
Shortness of breath (dyspnea).
Breathing problems.
Being really tired and having no energy (lethargic).
Feeding problems.

It’s very rare for a child with TAPVR not to show symptoms as soon as they’re born. In very few cases, symptoms won’t appear until they’re several months old.

Testing for TAPVR

After birth, if your child’s healthcare provider suspects TAPVR, they’ll give your child a transthoracic echocardiogram (TTE) to see the structure of their heart and veins. They may also do other tests like:

Meet Our TAPVR Team

Your baby will get the very best care possible at Cleveland Clinic Children’s from a team of specialists dedicated to their unique needs. Their personalized team may include:

Pediatric cardiologists.

Pediatric cardiothoracic surgeons.

Pediatricians.

Pediatric nurse practitioners.

Social workers.

Providers Who Treat Total Anomalous Pulmonary Venous Return

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Treating TAPVR at Cleveland Clinic Children’s

TAPVR is a serious heart condition, which we treat with open-heart surgery. We do this surgery as soon as we can after your child’s diagnosis to help restore normal blood flow to their heart.

Our surgical team uses general anesthesia to help your baby sleep. They won’t feel any pain or discomfort during the surgery. The surgeons will make cuts (incisions) in your baby’s chest and heart to move the veins to the correct spot.

Most children with TAPVR also have a hole between their heart’s right and left atriums (atrial septal defect, or ASD). If your child has an ASD, we’ll repair it during this same surgery.

Recovery and Follow-up Care

After your child has open-heart surgery, they’ll spend one or two days in the pediatric intensive care unit (ICU). They’ll get medications and fluids through an IV (in their vein) and stay in the hospital for two to four weeks as they recover. Full recovery can take at least six to 12 weeks for open-heart surgery. We’ll help you learn how to best care for your child after they go home.

Follow-up care for TAPVR means lifelong checkups. These regular follow up visits help your child’s care team keep an eye out for other conditions and complications like narrowing of their pulmonary veins (pulmonary artery stenosis), irregular heartbeats (arrhythmia), abnormal heart function or infections.

Depending on the type of surgery and outcome, your child may need to take antibiotics before dental work to lower their risk of serious heart infections from bacteria (endocarditis). Your care team will go over what to expect during recovery.

Taking the Next Step

When your baby is born with a serious heart condition like total anomalous pulmonary venous return, getting a diagnosis and treatment right away can be lifesaving. Our pediatric cardiology specialists are here to diagnose this condition and repair your child’s heart right away. We also understand that even when it’s necessary, surgery can be an overwhelming step to take with your child. That’s why we’re here to support you, too, with compassion and understanding.