Unnoticed bilateral partial anomalous pulmonary vein connection

Abstract

Partial anomalous pulmonary vein connection (PAPVC) is characterized by drainage of 1 or more pulmonary veins (butnot all)into theright atrium orone ofits tributary veins. Anomalous connections of the left pulmonary veins are rare. Bilateral PAPVC is extremely unusual. We report the case of a patient who underwent surgical closure of the atrial septal defect (ASD), ventricular septal defect (VSD), and correction of the left superior pulmonary vein drainage at the age of 7 months. Subsequent postoperativecontrolsshowednoevidenceofrightchamberoverload regression. We performed cardiac magnetic resonance imaging (MRI) that showed a PAPVC of the right superior pulmonary vein to the superior vena cava and a PAPVC of the left inferior pulmonary vein to the left suprahepatic vein through a collector. The child underwent definitive surgical correction at the age of 5 years. Postoperative recovery was uneventful. Predischarge transthoracic echocardiogram showed an important reduction of the volume of the right chambers. PAPVC is characterized by drainage of 1 or more pulmonary veins, but not all, into the right atrium or one of its tributary veins. It often involves the right superior pulmonaryvein.Anomalousconnectionsoftheleftpulmonaryveins are rare. Bilateral PAPVC is extremely unusual (1%-2%). 1 BilateralPAPVCusuallyinvolvestheupperlobeofbothlungs with the left superior pulmonary vein draining into the left innominate vein through an anomalous vertical vein. 1,2