Pięciomiesięczne niemowlę z całkowitym nieprawidłowym spływem żył płucnych – opis przypadku

Abstract

Total anomalous pulmonary venous return (TAPVR) is a rare congenital cyanotic heart disease, in which the lack of connection between all four pulmonary veins and left atrium is present. The interatrial communication allows the oxygenated blood flow to systemic circulation through the left atrium. The authors present a 5-month-old girl with heart failure symptoms. Poor weight gain, feeding difficulties, tachypnoe with use of accessory breathing muscles, hepatomegaly and low oxygen saturation level were observed. Serum concentration of NT-proBNP was elevated. Electrocardiography revealed right atrial and right ventricular enlargement. Chest X-Ray showed cardiomegaly and increased pulmonary vascular markings. The echocardiographic evaluation revealed pulmonary venous drainage to superior vena cava, right-sided heart chambers enlargement, main pulmonary artery dilation and atrial septal defect. Computed tomographic angiography was performed in order to acquire more accurate image of pulmonary veins connection. Supracardiac type of total anomalous pulmonary venous return was diagnosed and cardiosurgical correction was performed. The authors pay attention to the importance of recognizing the clinical symptoms of heart failure in infants by primary care physicians.