Total anomalous pulmonary venous return

now this time in ta PVR we're dealing with the pulmonary veins that happens to be the one thing I didn't draw but let's label what I did draw we have the right atrium receiving blood from the body going to the right ventricle pumping it to the lungs through the pulmonary arteries and then the pulmonary veins are the things that give blood back to the atrium on the left side from the lungs see pulmonary meaning it comes from the lungs and then means it's going back to the heart instead of artery which is away from the heart so the lungs giving oxygenated red blood back to the left atrium those are our pulmonary veins and we have the left ventricle which pumped it to the body another thing what ta PVR is instead of it being plugged over here where it's supposed to be our pulmonary veins are plugged over here into the right ventricle we draw to here coming from the left and right lungs so the right ventricle usually receives blue deoxygenated blood from the body but now we've got red blood from the lungs coming back here too so let's see there's a D action and a blue blood from the veins and red blood so here our right atrium is receiving this mixture again this purplish kind of blood is floating around in our right atrium and from there the rest of the circuit is the same goes to the right ventricle it goes to the lungs so again we have purple blood going out to our lungs but from there the blood picks up enough oxygen to become right again and it comes back through these Mis plug pulmonary veins right here as you can see there's nothing going on on the left side it's as if the this chamber is sealed off there's nothing coming back into the left atrium and therefore this is all empty that means there's nothing going on in the aorta there's no blood being pumped to the body as you know that's not compatible with life so usually ta PVR also involves a 8's D so atrial septal which is the wall between them septal defect so thankfully we have a hole between the left and right atria here no hole so that our purple blood can go this way and the left atrium will be filled from the right side with purple blood and now this purple blood can then go into the left ventricle and out through the aorta into the body because without this little hole here then we just have deoxygenated blood coming from the body mixing there with the red blood from the lungs into purple blood going back to the lungs and coming back as red blood now we have again this closed circuit is nothing to do with the body and we can't survive without blood going into our area into the body so this closed system has to be open and that's why we have the ASD here to allow the mixed blood into the left sides we can survive usually this also involves a right ventricular hypertrophy because look it's doing twice the work it's used to it's just an overwhelming amount of volume of blood going to the right side so this increased workload will give us the right ventricular hypertrophy as well and this again use surgical correction to we plug the pulmonary veins back where they belong so just remember these misplace pulmonary veins when you think of TA PBR