Abstract
Generalized cyanosis in newborn can be caused by many pathological conditions and cyanotic congenital heart disease represents one of the important causes. Differential cyanosis refers to the situation where upper limb saturation is higher than lower limb and it is well documented to be caused by persistent pulmonary hypertension in newborn
Highlights
Generalized cyanosis in newborn can be caused by many pathological conditions and cyanotic congenital heart disease represents one of the important causes
We reported two neonates with obstructed supracardiac total anomalous pulmonary venous drainage (TAPVD) presented with reverse differential cyanosis
We reviewed the pathophysiology of supracardiac TAPVD in causing reverse differential cyanosis and highlighted the importance of considering TAPVD as the differential diagnosis to facilitate early treatment
Summary
Generalized cyanosis in newborn can be caused by many pathological conditions and cyanotic congenital heart disease represents one of the important causes. Post-bypass transoesophageal echocardiography showed widely patent anastomosis between the pulmonary venous chamber and the left atrium, moderately dilated right ventricle with impaired systolic function, mild tricuspid regurgitation with estimated right ventricular systolic pressure (RVSP) being two-third systemic and a small residual atrial communication 1.5mm with left-to-right shunting. Both upper and lower limb oximetry were the same at 98-100% after operation. Post-operatively, the pulmonary venous drainage to the left atrium showed no obstruction
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