Meandering Pulmonary Vein Research Articles

Scimitar Syndrome with Different Features in Pediatric Patients: A Single-Center Experience

Purpose: Scimitar syndrome is a rare congenital cardiac anomaly in which pulmonary veins are drained to the inferior vena cava (IVC) instead of the left atrium and it is often associated with additional cardiac and pulmonary anomalies. Scimitar syndrome has a wide range of anatomic and clinical variations. In this article, the different clinical features of five pediatric patients with Scimitar syndrome are reported.
 Material and methods: Five patients with scimitar syndrome were diagnosed in our hospital between 2000 and 2020. The clinical findings, angiographic and surgical procedures, and follow-up of the patients are evaluated.
 Results: Five pediatric patients aged between 1.5 months and 10 years were diagnosed as Scimitar syndrome; two of the five patients were infants. All patients were symptomatic. One patient had cor triatriatum and pulmonary venous stenosis, one patient had left atrial isomerism and absence of the IVC (azygous continuity), and another patient had coarctation of the aorta. One patient had dual drainage: the IVC and left atrium with meandering pulmonary veins, which we determined as a Scimitar variant. One infant patient with pulmonary hypertension and two patients with pulmonary to systemic flow ratio (Qp/Qs) >1.5 were treated surgically with the reanastomosis technique. Transcatheter occlusion of the aortopulmonary collaterals was performed in two patients using vascular plugs, coils, and onyx.
 Conclusion: In this article, the clinical findings of five pediatric patients with Scimitar syndrome were evaluated in detailed. Treatment should be planned individually in this syndrome due to Scimitar syndrome has a wide range of anatomic and clinical variations.

Meandering pulmonary vein: a variant of the "scimitar" syndrome

The paper presents a clinical case of a 38-year-old woman who had an anomalous confluence of the right pulmonary vein, both into the inferior vena cava and into the left atrium, which corresponds to be the "scimitar" syndrome. The abnormal pulmonary vein made several bends before draining into the left atrium, which is described in foreign literature as a "meandering pulmonary vein". To clarify the diagnosis, a CT scan of the chest with bolus contrast enhancement and a deep analysis of literature sources were performed.

Role Of Multi-detector Computed Tomographic Angiography In Delineation Of Pulmonary Venous Variants And Anomalies.

AbstractBackground: Diagnostic imaging is crucial in the evaluation of thoracic congenital anomalies. Although clinical assessment may provide insight into the possible diagnosis, imaging is usually necessary to confirm the diagnosis, treatment planning and postoperative evaluation.Aim: To assess the role of multidetector computed tomography (MDCT) in evaluating and calculating prevalence of pulmonary venous abnormalities, and be familiar with the imaging characteristics of these abnormalities.Patients and methods:Ninety patients were enrolled in this retrospective study (33.3% males and 66.7% females) their age ranged from 10 days to 60 years (mean age: 28.7±19.6 years), who underwent MDCT angiography using 128-slice MDCT scanner (ingenuity Philips health care, best, Netherlands) and have been diagnosed of pulmonary venous variants or anomalies.Results:Pulmonary venous anomalies were detected in 12.2 % of the studied group while the pulmonary variants were 20%. The most common pulmonary venous congenital anomalies were partial anomalous pulmonary venous return (PAPVR) (45.5%) then pulmonary venous varix (27.3 %), followed by total anomalous pulmonary venous return (TAPVR) representing (18.2%) then the meandering pulmonary vein representing (9%) of detected anomalies. While the most common pulmonary venous variant is conjoined pulmonary vein representing 10 % followed by supernumerary right pulmonary vein representing 5.6 % then pulmonary vein open with common ostium representing 4.4% of the studied group. Conclusion:(MDCT) is considered the modality of choice for accurate delineation of pulmonary venous normal and variant anatomy as well as anomalies and aids planning of interventional procedures especially radiofrequency ablation of arrhythmiogenic foci.

A Complex Pulmonary Vascularization: Bilateral Meandering Pulmonary Veins

A Complex Pulmonary Vascularization: Bilateral Meandering Pulmonary Veins

A Complex Pulmonary Vascularization: Bilateral Meandering Pulmonary Veins

A Complex Pulmonary Vascularization: Bilateral Meandering Pulmonary Veins

Meandering pulmonary vein: Very rare incidental finding

Meandering pulmonary vein (MPV) is a rarely seen pulmonary vascular anomaly and confused with the scimitar syndrome which is more commonly seen. In this paper, we presented a case of left MPV which mimes arteriovenous malformation. A 30-year-old man was referred to our clinic for pulmonary nodule detected in routine evaluation before employment examination. Diagnosis of MPV was made by Pulmonary CT angiography. It showed abnormal drainage of upper lob pulmonary vein to the inferior pulmonary vein and form abnormal common pulmonary vein which shouldn't be exist. Because of any symptoms no further examination was recommended. According to our best knowledge to date only 17 cases reported in the literature. MPV diagnosis has been significantly changed by the means of advances in CT technology. Non-invasive diagnosis is possible with modern multisectional CT that clearly shows the anatomy of veins and enables the detailed MPV examination. Hereby, unnecessary radiological examination or surgery can be prevented.f veins and enables the detailed MPV examination.

An unusual cause of respiratory distress in an infant.

Partial anomalous venous connection (PAPVC) is a congenital cardiovascular defect where one or more (but not all) of the pulmonary veins return anomalously back to the right atrium, either via a direct or indirect connection. It often occurs with other cardiac defects, most commonly a secundum atrial septal defect. Individuals with a large degree of shunting will present with dyspnea, fatigue, and, in some cases, heart failure. Clinical associations and variants of PAPVC include scimitar syndrome, pseudo-scimitar or meandering right pulmonary vein, sinous venosus defects, malposition of the septum primum, and Turner syndrome. The patient in this case, a previously healthy, 6-month-old, full-term male, presented to the emergency department for evaluation of respiratory distress and wheezing. The infant was first seen in his pediatrician's office, where he was noted to be tachypneic and wheezing. He was feeding without difficulty, voiding well, and was active and playful. The patient had passed critical congenital heart disease screening after his birth and prior to discharge, and the family history was negative for any respiratory or cardiac conditions. Cardiac magnetic resonance imaging is becoming the mode of choice for diagnosis of PAPVC. The definitive treatment is surgical correction, but surgery is not indicated in all cases, especially if the patient is asymptomatic and the degree of shunting is small. Patients with isolated PAPVC who undergo surgical correction have good long-term outcomes. In this case, the patient underwent the Warden procedure, which causes an increased risk of superior vena cava stenosis or obstruction to the right atrium. This patient will require lifelong follow-up to assess for new onset pulmonary venous obstruction.

Three-dimensional computed tomography reveals anatomical variant of meandering pulmonary vein

Figure 2: 3D-CT demonstrated a meandering pulmonary vein forming a loop, and draining into the superior pulmonary vein. It resembles a scimitar vein, but ultimately drains normally into the left atrium. The inferior pulmonary vein appeared normal. SPECT/CT demonstrated a defect in the S3/S4 area of the left lung. The area of the defect corresponded to the loop formed by the meandering pulmonary vein. It was suspected that within the loop no blood was supplied by the pulmonary circulation.

Pseudo-Scimitar syndrome

The pulmonary venous abnormalities are very rare and are difficult to diagnose. We present a case of middle age male who presented with cough and chest pain. Chest radiograph showed abnormal tortuous vessel in right lung. Computed tomographic angiography of chest demonstrated meandering anomalous right superior pulmonary vein.

Meandering pulmonary veins with a common inferior trunk: an anomalous left inferior pulmonary vein entering an anomalous right inferior pulmonary vein

We report an unusual case of an asymptomatic 56-year-old woman in whom an anomalous left inferior pulmonary vein was noted to drain into the meandering right inferior pulmonary vein and the common inferior vein normally entered the left atrium. These findings were confirmed by three-dimensional computed tomography. To the best of our knowledge, this is the first reported case of meandering pulmonary veins with a common inferior trunk.

Scimitar syndrome versus meandering pulmonary vein: evaluation with three-dimensional computed tomography

We report two cases of abnormal configuration of the pulmonary venous system of the right lung evaluated with the use of three-dimensional spiral computed tomography (3D-CT). In the first case, an unusual form of scimitar syndrome was detected, consisting of two scimitar veins uniting into a common trunk immediately before their confluence into the inferior vena cava (IVC). The second case concerns a meandering pulmonary vein that followed a circuitous course through the right lung and came in close proximity to the IVC, before draining the entire right lung to the left atrium. In both cases, 3D-CT enabled a non-invasive, detailed anatomic evaluation of the right pulmonary vascular bed.

A familial variant of the Scimitar syndrome with a meandering pulmonary vein

We report a rare variant of the Scimitar syndrome, in which the right lower pulmonary vein takes a meandering course before finally connecting in normal fashion to the left atrium. The pulmonary parenchymal segment drained by the tortuous vein is supplied by a systemic collateral artery, which was coiled via a catheter. We also closed the intracardiac defects by surgery. The elder brother of the patient had classical Scimitar syndrome.