CASE REPORT
Total anomalous pulmonary vein drainage in a 60-year-old woman diagnosed in an ECG-gated multidetector computed tomography – a case report and review of literature
Publication date: 2018-07-05
Pol J Radiol, 2018; 83: 334-339
KEYWORDS
pulmonary veinscongenital heart diseasetotal anomalous pulmonary venous drainagemultidetector computed tomography
ABSTRACT
Purpose:
Total anomalous pulmonary vein drainage (TAPVD) is a congenital cardiac defect in which there is no connection between pulmonary veins and the left atrium. Pulmonary veins form a confluence independent of the left atrium and drain to a systemic vein. TAPVD types are: supracardiac, cardiac, infracardiac, and mixed. TAPVD accounts for approximately 1.5-2.2% of all congenital heart diseases. This anomaly is usually diagnosed in the neonatal period, and it coexists with atrial septal defect. Adult cases of TAPVD are rarely reported.
Case report:
We report a rare case of a 60-year-old woman with incidentally found, uncorrected TAPVD in ECG-gated multidetector computed tomography. In previous echocardiographic examinations partial anomalous pulmonary venous return and atrial septal defect were diagnosed.
Conclusions:
ECG-gated multidetector computed tomography is a valuable diagnostic method for adults with congenital heart disease. It enables evaluation of coronary arteries and simultaneously provides detailed anatomy of great vessels.
Total anomalous pulmonary vein drainage (TAPVD) is a congenital cardiac defect in which there is no connection between pulmonary veins and the left atrium. Pulmonary veins form a confluence independent of the left atrium and drain to a systemic vein. TAPVD types are: supracardiac, cardiac, infracardiac, and mixed. TAPVD accounts for approximately 1.5-2.2% of all congenital heart diseases. This anomaly is usually diagnosed in the neonatal period, and it coexists with atrial septal defect. Adult cases of TAPVD are rarely reported.
Case report:
We report a rare case of a 60-year-old woman with incidentally found, uncorrected TAPVD in ECG-gated multidetector computed tomography. In previous echocardiographic examinations partial anomalous pulmonary venous return and atrial septal defect were diagnosed.
Conclusions:
ECG-gated multidetector computed tomography is a valuable diagnostic method for adults with congenital heart disease. It enables evaluation of coronary arteries and simultaneously provides detailed anatomy of great vessels.
REFERENCES (26)
1.
Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890-1900.
2.
Dillman JR, Yarram SG, Hernandez RJ. Imaging of pulmonary venous developmental anomalies. AJR Am J Roentgenol 2009; 192: 1272-1285.
3.
Ashfaq A, Shah N, Khan MZ, et al. Successful surgical intervention of total anomalous pulmonary venous drainage in the third decade of life. Ann Med Surg (Lond) 2013; 2: 60-62.
4.
Nabati M, Bagheri B, Habibi V. Coincidence of total anomalous pulmonary venous drainage to the superior vena cava, common atrium, and single ventricle: a very rare condition. Echocardiography 2013; 30: E98-101.
5.
Oliver JJ, Michael HC, English KM, et al. Unusual Causes of Late Right Heart Dilatation Long After Repair of Total Anomalous Pulmonary Venous Drainage. Circulation 2013; 127: 258-259.
6.
Craig JM, Darling RC, Rothney WB. Total pulmonary venous drainage into the right side of the heart; report of 17 autopsied cases not associated with other major cardiovascular anomalies. Lab Invest 1957; 6: 44-64.
7.
Beigel R, Wunderlich NC, Ho SY, et al. The left atrial appendage: anatomy, function, and noninvasive evaluation. JACC Cardiovasc Imaging 2014; 7: 1251-1265.
8.
Burke SJ, Aggarwala G, Stanford W, et al. Preablation assessment for the left atrium: comparison of ECG-gated cardiac CT with echocardiography. Acad Radiol 2008; 15: 835-843.
9.
Agarwal SC, Bittinger L, Tang AS. Importance of superior vena cava isolation in successful ablation of persistent atrial fibrillation in patient with partial anomalous pulmonary vein. Pacing Clin Electrophysiol 2013; 36: e146-149.
10.
Schreiber D, Müller K, Kottkamp H. Catheter ablation in a patient with paroxysmal atrial fibrillation and partial anomalous pulmonary vein connection. J Cardiovasc Electrophysiol 2011; 22: 717.
11.
Fukamizu S, Sakurada H, Nishizaki M, Hiraoka M. Catheter ablation in a patient with partial anomalous pulmonary venous return and atrial fibrillation. Heart Rhythm 2012; 9: 1002-1003.
12.
Huang H, Yang B, Jiang H, et al. Catheter ablation of paroxysmal atrial fibrillation in a young patient with a partial anomalous pulmonary venous connection. Chin Med J (Engl) 2010; 123: 2284-2286.
13.
Braksator W, Kuch M, Difenbach C, et al. Two-dimensional transesophageal echocardiography (clinical value). Kardiol Pol 1992; 37: 383-388.
14.
Gathman GE, Nadas AS. Total anomalous pulmonary venous connection: clinical and physiologic observations of 75 pediatric patients. Circulation 1970; 42: 143-154.
15.
Ogawa M, Nakagawa M, Hara M, et al. Total anomalous pulmonary venous connection in a 64-year-old man: a case report. Ann Thorac Cardiovasc Surg 2013; 19: 46-48.
16.
Talwar S, Choudhary SK, Reddy S, et al. Total anomalous pulmonary venous drainage beyond childhood. Interact Cardiovasc Thorac Surg 2008; 7: 1058-1061.
17.
Nurkalem Z, Gorgulu S, Eren M, et al. Total anomalous pulmonary venous return in the fourth decade. Int J Cardiol 2006; 113: 124-126.
18.
Feng Q, Wu S, Yu G. Surgical treatment of a 56-yearold woman with an intracardiac type of total anomalous pulmonary venous connection. Thorac Cardiovasc Surg 2010; 58: 175-176.
19.
Kong D, Pan C, Dong L, et al. Rare variant of mixed total anomalous pulmonary venous drainage (TAPVD) in a 55-year-old patient. Eur Heart J Cardiovasc Imaging 2015; 16: 227.
20.
Funabashi N, Takaoka H, Irie R, et al. Supra-cardiac type (1a) total anomalous pulmonary venous return with right to left shunt atrial septal defect diagnosed by 320 slice CT. Eur Heart J 2015; 36: 1776.
21.
Kantarci M, Yuce I, Yalcin A, et al. Evaluating adult cor triatriatum with total anomalous pulmonary venous connections by multidetector computer tomography angiography. Folia Morphol 2011; 70: 312-314.
22.
Singh N, Singh R, Aga P, et al. Cardiac type of total anomalous pulmonary venous connection: diagnosis and demonstration by multidetector CT angiography. BMJ Case Rep 2013; doi:10.1136/bcr-2012-007994.
23.
Oh KH, Choo KS, Lim SJ, et al. Multidetector CT evaluation of total anomalous pulmonary venous connections: comparison with echocardiography. Pediatr Radiol 2009; 39: 950-954.
24.
Dyer KT, Hlavacek AM, Meinel FG, et al. Imaging in congenital pulmonary vein anomalies: the role of computed tomography. Pediatr Radiol 2014; 44: 1158-1168.
25.
Ratajczak P, Sławińska A, Martynowska-Rymer I. Anatomical Evaluation of the Pulmonary Veins and the Left Atrium Using Computed Tomography Before Catheter Ablation: Reproducibility of Measurements. Pol J Radiol 2016; 81: 228-232.
26.
Restrepo MS, Cerqua A, Turek JW. Pentalogy of Cantrell with ectopia cordis totalis, total anomalous pulmonary venous connection, and tetralogy of Fallot: a case report and review of the literature. Congenit Heart Dis 2014; 9: E129-134.
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