Direct operating room triage of neonates with total anomalous pulmonary venous connection.

Total anomalous pulmonary venous connection with obstruction constitutes a surgical emergency. Medical therapy is palliative and unlikely to result in significant or sustained physiologic improvement. Two cases demonstrate the successful use of a novel management scheme in which patients are admitted directly to the operating room for diagnosis confirmation and treatment, obviating the need for time-consuming preoperative assessment in an intensive care unit before surgery.