Total anomalous pulmonary venous connection.

Total anomalous pulmonary venous connection (TAPVC) is subdivided into four types: supracardiac, cardiac, infracardiac, and mixed. The principle of operative repair is to establish an unobstructed communication between the pulmonary veins and the left atrium, interrupt the connections with the systemic venous circulation, and remove intracardiac shunting. The specific repair is dependent on the type of anomalous connection. Pulmonary venous obstruction is a significant and complex complication following TAPVC repair. The introduction of the sutureless pericardial marsupialization technique has greatly improved the outcome in this difficult patient group.