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Case Reports
. 2024 Mar 8;8(3Part A):97-102.
doi: 10.1016/j.case.2023.12.015. eCollection 2024 Mar.

Pulmonary Veins: Not Always Where You Expect Them

Kathryn I Sunthankar  1 , Angela J Weingarten  1   2 , Thomas P Doyle  2 , George T Nicholson  2 , Sudeep D Sunthankar  2
Affiliations
Case Reports

Pulmonary Veins: Not Always Where You Expect Them

Kathryn I Sunthankar et al. CASE (Phila). .
No abstract available

Keywords: Adult congenital heart disease; Cardiac MRI; Device occlusion; Total anomalous pulmonary venous return.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Diagrams demonstrating the original anatomy with pulmonary venous confluence posterior to the left atrium (LA) with the VV draining into hepatic vein (A), anatomy and hemodynamics at the time of cardiac catheterization with stenotic entry of lower PVs to the LA and VV intact (B), and hemodynamics following interventions (C). LLPV, Left lower PV; LUPV, left upper PV; RLPV, right lower PV; RUPV, right upper PV.
Figure 2
Figure 2
Timeline demonstrating key data points from clinical, cardiac imaging, and hepatic evaluations. ASD, Atrial septal defect; CPET, cardiopulmonary exercise testing; EDV, end-diastolic volume; HE, hepatic elastography; LA, left atrium; PDA, patent ductus arteriosus; RA, right atrial; RER, respiratory exchange ratio; RHC, right heart catheterization; VCO2, carbon dioxide production; VE, minute ventilation; VO2, oxygen uptake.
Figure 3
Figure 3
TTE images from the patient’s first study demonstrate normal left ventricular size and function and mild RV enlargement (RV length 8.3 cm, RV basal diameter 6.4 cm, RV midcavitary diameter 5.3 cm) and normal systolic function (RVEF 49%). Apical four-chamber views in diastole (A) and systole (B). Right upper PV Doppler captured in apical three-chamber (C) and four-chamber views (D). Subcostal view demonstrates the VV draining directly into the hepatic vein, with a minimal gradient of 4 mm Hg (E, F).
Figure 4
Figure 4
Three-dimensional CMR, whole-heart, volume-rendered reconstruction, demonstrates the left (blue arrow) and right (green arrow) lower PVs draining to the VV (white arrow), which descends caudally to the portal venous system.
Figure 5
Figure 5
CCT, multiplanar reconstructions, axial (A) and sagittal (B) displays, demonstrates the stenotic insertion of the VV into the LA.
See this image and copyright information in PMC

References

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    1. Delisle G., Ando M., Calder A.L., Zuberbuhler J.R., Rochenmacher S., Alday L.E., et al. Total anomalous pulmonary venous connection: report of 93 autopsied cases with emphasis on diagnostic and surgical considerations. Am Heart J. 1976;91:99–122. - PubMed
    1. Karamlou T., Gurofsky R., Al Sukhni E., Coles J.G., Williams W.G., Caldarone C.A., et al. Factors associated with mortality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation. 2007;115:1591–1598. - PubMed
    1. Al-Muhaya M.A., Alkodami A.A., Khoshhal S., Najjar A.H.A., Al-Mutairi M., Abdelrehim A.R. Transcatheter occlusion of the vertical vein in a partial anomalous pulmonary venous connection with dual Drainage, case series with literature review. Int J Cardiol Heart Vasc. 2021;37 - PMC - PubMed
    1. Gangadhara M.B., Magee A.G. Transcatheter occlusion of partial anomalous pulmonary venous connection with dual drainage to left atrium. Ann Pediatr Cardiol. 2019;12:144–146. - PMC - PubMed

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