In a condition known as total anomalous pulmonary venous return, all of the blood returning from the lungs enters the right heart and joins with the blood returning from the body. These babies may also appear well for a short period of time before becoming very ill. If an associated ventricular septal defect is present, the degree of cyanosis may not be low enough to be visible. Significant cyanosis is also seen when then blood vessels to heart and lungs connect with the wrong ventricles. In transposition of the great arteries, the right heart pumps blood into the aorta and the left heart pumps blood into the pulmonary artery. The heart problems in which the left heart helps to supply the lungs with blood because of a problem on the right side of the heart are occasionally associated with oxygen saturations which are low enough to cause visible cyanosis. These defects include, but are not limited to tricuspid atresia, pulmonary atresia with intact ventricular septum, pulmonary atresia with VSD, tetralogy of Fallot, and truncus arteriosus. The heart problems in which the right heart helps to supply body with blood because of a problem on the left side of the heart are those most commonly missed. These defects include, but are not limited to hypoplastic left heart syndrome, critical aortic stenosis, coarctation of the aorta, and interrupted aortic arch. In all of these problems, there is something that prevents the left heart from delivering blood from the lungs to the body. There are a number of different types of heart problems that may be missed in the blind spot. The common thread in these lesions is that the ductus provides a significant amount of blood to either the body or the lungs. The following diagrams demonstrate some of the heart defects in which a child may appear well in the first day or two after birth, only to become ill when the ductus arteriosus closes. Hematology, Oncology & Bone Marrow Transplant.General Pediatrics & Adolescent Medicine.Gastroenterology, Hepatology & Nutrition.Developmental Pediatrics & Rehabilitation Medicine.Seminars in Pediatrics 2022- Enduring Content Now Available!.
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