Systemic and Pulmonary Venous Anomalies

Abstract

Assessment of systemic and pulmonary venous anatomy represents a vital part of the echocardiographic evaluation of any patient with suspected congenital heart disease (CHD). Systemic and pulmonary venous anomalies can occur as known associations with both simple and complex forms of CHD, and their presence (or absence) can have important clinical implications. Moreover, knowledge of systemic and pulmonary venous return is necessary for the accurate classification of some of the more complex forms of CHD, and for understanding the underlying physiology in such patients. Anyone performing echocardiographic evaluation of possible systemic/pulmonary venous anomalies should have a comprehensive understanding of the normal anatomy of both systems, as well as the more common abnormalities involving each system and associated hemodynamic alterations. Transesophageal echocardiography (TEE) is well suited for evaluation of both systemic and pulmonary venous anomalies, due to the proximity of the esophagus and transducer to the sites of venous return and to the atrial chambers. This chapter presents a thorough discussion of congenital systemic and pulmonary venous anomalies and their evaluation by TEE.