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Case Reports
. 2016 May 14;11(3):134-7.
doi: 10.1016/j.radcr.2016.04.005. eCollection 2016 Sep.

Computed tomography features of supracardiac total anomalous pulmonary venous connection in an infant

Tariq Alam  1 , Hidayatullah Hamidi  2 , Mer Mahmood Shah Hoshang  2
Affiliations
Case Reports

Computed tomography features of supracardiac total anomalous pulmonary venous connection in an infant

Tariq Alam et al. Radiol Case Rep. .

Abstract

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital anomaly of the pulmonary veins drainage. In this entity, the pulmonary veins, instead of draining to left atrium, connect abnormally to the systemic venous circulation. A right-to-left shunt is obligatory for survival. Based on its type and degree of pulmonary venous obstruction, TAPVC may result in pulmonary hypertension and congestive heart failure. In severe cases, urgent diagnosis and surgical correction is essential to reduce morbidity and mortality. Echocardiography as the first and safest imaging modality for cardiovascular abnormalities may fail in complete depiction of some complex feature of TAPVC. Computed tomography angiography is then a noninvasive and sensitive choice for mapping the pulmonary veins without the need for invasive cardiac catheterization. Contrast-enhanced MR angiography can be a radiation-free alternative. Authors present a computed tomography-detected supracardiac TAPVC with small patent ductus arteriosus in a 2 months cyanotic infant.

Keywords: anomalous pulmonary venous connection; congenital heart disease; cyanosis.

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Figures

Fig. 1
Fig. 1
Axial (right) and coronal (left) postcontrast computed tomography sections: the right pulmonary veins (RPVs) and left pulmonary veins (LPVs) join all together posterior to the left atrium (LA) and left ventricular outlet (LVO). The confluence of PVs (red star) converges into a large left vertical vein (LVV) that is ascending lateral to the pulmonary trunk (PT). The superior vena cava (SVC), right atrium (RA), right ventricle (RV), and even left internal jugular vein (IJV) are dilated. The pulmonary truck (PT) is prominent compared to the ascending aorta (AA) at the same level.
Fig. 2
Fig. 2
Reformatted axial image at atrial level: the right atrium (RA) is dilated, whereas the left atrium (LA) has smaller size. The small atrial septal defect (ASD) is well depicted. The congested lung vessels can also be seen.
Fig. 3
Fig. 3
VRT (right) and MPR (left) reformatted coronal images through the abnormal pulmonary venous pathway: the left vertical vein (LVV), the left brachiocephalic (innominate) vein (BCV), and the superior vena cava (SVC) as well as the right atrium (RA), and right ventricle (RV) are well depicted. This whole pathway is dilated and even early reflux of contrast to the dilated inferior vena cava (IVC) is also seen. The cardiac apex is elevated representing dilatation of the right heart.
See this image and copyright information in PMC

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