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Case Reports
. 2020 Jun 24;4(2):141-144.
doi: 10.1002/ped4.12204. eCollection 2020 Jun.

Obstructed infracardiac total anomalous pulmonary venous connection: The challenge of palliative stenting for the stenotic vertical vein

Mansour Al-Mutairi  1   2 , Adnan Aselan  2 , Mustafa Al-Muhaya  1 , Hany Abo-Haded  2   3
Affiliations
Case Reports

Obstructed infracardiac total anomalous pulmonary venous connection: The challenge of palliative stenting for the stenotic vertical vein

Mansour Al-Mutairi et al. Pediatr Investig. .

Abstract

Introduction: Obstructed total anomalous pulmonary venous connection (TAPVC) is one of the commonest seen emergencies in pediatric cardiology centers.

Case presentation: Our case was diagnosed to have this anomaly, showing early respiratory distress resulting from severe pulmonary congestion. Palliative stenting of the obstruction was done, which helped in stabilizing the debilitated hemodynamics of the baby before surgery, thus a good surgical outcome and prognosis are expected.

Conclusion: This intervention may be listed as a vital measurement in the preoperative cardiac stabilization plan for infants with obstructed TAPVC.

Keywords: Obstruction; Palliative stent; Total anomalous pulmonary venous connection (TAPVC).

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Echocardiography imaging of the neonate with obstructed infracardiac type total anomalous pulmonary venous connection (TAPVC) revealed (A) Mirror‐image dextrocardia, dilated RA, ASD, and small‐sized LA with no attached pulmonary veins. (B) Large inlet to outlet VSD. (C) Bilateral SVC attached to RA, and single VV going downward behind the heart. (D) VV tracked down to the IVC. (E) Turbulence at site of entry of VV into IVC. (F) Doppler of VV flow. RA, right atrium; LA, left atrium; ASD, atrial septal defect; VSD, ventricular septal defect; SVC, superior vena cava; IVC, inferior vena cava; VV, vertical vein.
FIGURE 2
FIGURE 2
Computed tomography angiography revealing infracardiac type total anomalous pulmonary venous connection (TAPVC) with a vertical vein going downward (with a lower stenotic segment), and four pulmonary veins joining it separately. Lt PVs, left pulmonary veins; Rt PVs, right pulmonary veins; VV, vertical vein.
FIGURE 3
FIGURE 3
Pulmonary artery angiograms with levo‐phase showing vertical vein joining the inferior vena cava with a stenotic lowest segment in the neonate with total anomalous pulmonary venous connection. (A) Anteroposterior view. (B) Lateral view. Lt PVs, left pulmonary veins; Rt PVs, right pulmonary veins; VV, vertical vein.
FIGURE 4
FIGURE 4
Dilation of the lower stenotic segment of the vertical vein prior to stent implantation in the neonate with total anomalous pulmonary venous connection. (A) Anteroposterior view. (B) Lateral view. VV, vertical vein.
FIGURE 5
FIGURE 5
Vertical vein angiogram of the neonate with total anomalous pulmonary venous connection. (A) Anteroposterior view. (B) Lateral view. Implantation of vertical vein stent. (C) Anteroposterior view. (D) Lateral view. VV, vertical vein.
FIGURE 6
FIGURE 6
Confluent angiogram with a good positioned patent stent with no inferior vena cava obstruction, and good flow to right atrium in the neonate with total anomalous pulmonary venous connection.
See this image and copyright information in PMC

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