Unusual form of total anomalous pulmonary venous connection with double drainage

Totally anomalous "double drainage" of pulmonary venous confluence: case report with embryological aspects

Double drainage of the confluence of all four pulmonary veins is extremely rare. We present the image findings in a child with double drainage of the pulmonary venous confluence into the coronary sinus and left superior caval vein with co-existent right superior caval venous stenosis.

Dual Drainage of TAPVR—An Exquisite Connection

Dual drainage or double-connection total anomalous pulmonary venous return (TAPVR) is a rare variant in which all four pulmonary veins enter a common venous chamber that then drains into the systemic veins via two or more channels at the supracardiac, cardiac, or infra-cardiac levels. The traditional classification of total anomalous pulmonary venous connection (TAPVC) does not categorize dual drainage separately.

We present a case of TAPVR with dual drainage in a 6-year-old child with a rare variety of connection.

Double drainage of total anomalous pulmonary venous connection revealed after surgical repair of a supracardiac total anomalous pulmonary venous connection

Mixed type TAPVC with double drainage, where the second vertical vein enlarged rather than atrophied after surgery. If we did not recognize left-to-right shunting before surgery, it can be treated with catheterization as demonstrated by our case.

A suggested new surgical classification for mixed totally anomalous pulmonary venous connection

The morphologic variations of mixed totally anomalous pulmonary venous connection are many and varied. In this review, we give an account of all cases previously described as mixed totally anomalous pulmonary venous connection, analyzing in detail those cases where an accurate anatomical description was provided. We identified 182 suitable cases, from 54 investigations, and reviewed the clinical presentation, anatomic variations, diagnostic features, and management of the patients described.Cross-sectional echocardiography, and cardiac catheterization, provided the necessary diagnostic information, and defined the anatomy before surgery in 139 patients. Magnetic resonance imaging and computerized tomographic angiography had been used for further clarification of the pulmonary venous anatomy. An obstructive pattern of drainage, involving one or more pulmonary veins, had been described in over half of the patients. We then grouped the lesions into categories that have a bearing on the appropriate surgical approach, discussing the appropriate repair for each group. For the overall group, the operative mortality remains high, at 22.9%. We submit that an increased appreciation of various types of mixed totally anomalous pulmonary venous connection may well contribute to improved future surgical management.

Asymptomatic Total Anomalous Pulmonary Venous Connection with Double Drainage in a Young Adult: A Case Report

Total anomalous pulmonary venous connection is an uncommon congenital anomaly in which all pulmonary venous return drains to the right atrium or one of its tributaries. Survival beyond infancy without surgical palliation is unlikely, so this anomaly is not encountered in the adult population with congenital heart disease. The patient presented here was 22 years old on admission and had no total anomalous pulmonary venous connection-associated symptoms. He underwent transthoracic echocardiographic examination for atypical chest pain. Transthoracic echocardiography along with cardiac catheterization favored the presence of a total anomalous pulmonary venous connection. Surgical correction of pulmonary venous confluence (draining to both the coronary sinus and right atrium) was performed successfully. This is a rare case of total anomalous pulmonary venous connection with no reported symptoms in contrast to the majority of patients who are symptomatic during the first year of life.