Abstract
The present series describes a group of adults with left-to-right shunts including partial anomalous pulmonary venous return (PAPVR) and/or an atrial septal defect (ASD) evaluated with ECG-gated 128-slice multidetector computed tomography (MDCT). PAPVR is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium. PAPVR involving the right upper pulmonary vein can be associated with a sinus venosus ASD. The presence, course, number of anomalous veins and associated cardiovascular defects can be reliably observed by 128-slice MDCT angiography.
Highlights
Partial anomalous pulmonary venous return (PAPVR) is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium
Anomalous right-sided pulmonary veins can drain into the superior vena cava (SVC), right atrium, inferior vena cava, azygos vein, hepatic vein or portal vein
PAPVR involving the right upper pulmonary vein can be associated with a sinus venosus atrial septal defect (ASD) located near the SVC orifice [1]
Summary
Partial anomalous pulmonary venous return (PAPVR) is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium. Case 1 A 38-year-old hypertensive male patient with a history of episodes of atrial fibrillation underwent TTE and TEE, which revealed unexplained dilatation of the right ventricle without an ASD or other intracardiac shunt. Case 2 A 34-year-old male patient with episodes of atrial fibrillation and shortness of breath was diagnosed with pulmonary hypertension and right-sided volume overload. The cause of these findings was not established with TTE. Case 3 A 70-year old female patient with heart failure, signs of right ventricular overload, and mild pulmonary hypertension underwent both TEE and catheter based angiography to establish the possible presence of cardiac shunts and the anatomy of the pulmonary veins. The veins from the right middle lobe and both lower lobes drained normally to the left atrium (Figure 5d)
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