Asociación entre conexión anómala parcial de venas pulmonares y atresia de venas pulmonares: reporte de caso

Abstract

IntroductionPartial anomalous pulmonary vein connection represents a spectrum of conditions in which one or more pulmonary veins are connected to a systemic vein, instead of their normal connection to the left atrium. The most common is the connection of the right superior pulmonary vein to the superior vena cava, which commonly occurs at the superior cavo atrial junction. Pulmonary vein atresia and/or stenosis occurs congenitally and acquired; in congenital cases there seems to be a defective incorporation of the common pulmonary trunks into the left atrium, leading to obstruction of some or all of its branches. Here we present the case of a patient with partial anomalous connection of pulmonary veins who also presents individual congenital atresia of the superior pulmonary vein and middle lobe. Materials and methods16 year old patient with clinical symptoms of dyspnea and palpitations on physical exertion for the last year. She was admitted for diagnostic and therapeutic catheterization, however, images suggesting that the superior and middle pulmonary veins drain into the right atrium were observed, so surgical correction was decided. ResultsSurgery was performed, finding absence of connection of right superior pulmonary veins and middle lobe to left atrium; ending in a blind sac in relation to left atrium, the lateral wall of left atrium was opened through the interatrial defect and terminal anastomosis of pulmonary veins to left atrium was performed. She was transferred to intensive care where she was extubated 8hours after the surgical procedure, monitored for 72hours and transferred to the service where she presented favorable evolution and was discharged without complications. ConclusionPulmonary vein stenosis and atresia are rare congenital malformations that can be treated satisfactorily surgically; however, the risk of stenosis is an important risk factor, so catheterization treatment is also a viable option.