Surgery for total anomalous pulmonary venous drainage in adults. Case reports and review of eight Japanese patients over 40 years of age.

In the majority of cases, total anomalous pulmonary venous drainage (TAPVD) results in death in infancy or early childhood, with very few cases surviving until adulthood. We report here the surgical correction of TAPVD in two adult patients, a 43-year-old male and 51-year-old female. The postoperative course was uneventful in the two patients, both of whom showed marked improvement of clinical features. The six other surgical corrections of TAPVD in patients over 40 years of age that have been reported in Japan are also reviewed. The favorable results in these cases were associated with the following common factors: 1) unobstructed forms with large drainage veins, 2) large interatrial communication, 3) normal pulmonary vascular resistance with normal or slightly elevated pulmonary artery pressure, 4) low grade, delayed cyanosis, and 5) the supracardiac type of TAPVD.