Intrapulmonary vertical vein associated with an infracardiac type of totally anomalous pulmonary venous connection

Anomalous Pulmonary Venous Connection With an Intraparenchymal Course

An intraparenchymal course of the pulmonary venous pathway within one lung in anomalous pulmonary venous connection is a rare and poorly recognized variation. We report three new cases and summarize the remaining 19 known cases of this infrequent anomaly. We expect that this review will call attention to this unusual pattern of pulmonary venous drainage and enhance prospective diagnosis.

Atypical pulmonary venous drainage pathway associated with infracardiac total anomalous pulmonary venous connection: report of a case

Darling's classification for total anomalous pulmonary venous connection (TAPVC) is based only on the level of the site of drainage of the anomalous pulmonary veins (PVs) to the systemic venous circulation. Although it is a clinically useful classification, atypical course of the PVs is occasionally encountered as well. We report a case of infracardiac-type TAPVC in which the left upper PV traversed the posterior mediastinum and merged into the right PVs at the right hilum. The combined vein coursed medially and caudally, meeting the left lower PVs, and finally penetrated the diaphragm; the pulmonary venous drainage formed a shape of "C." Despite definitive diagnosis according to Darling's classification, sometimes atypical course of the PVs do exist. Echocardiography may not be adequate for atypical cases. Contrast-enhanced computed tomography may be recommended in stable patients where an atypical course is suspected.