Atypical Case of Partial Anomalous Pulmonary Venous Connection Misdiagnosed as Primary Pulmonary Arterial Hypertension
DOI:
https://doi.org/10.1532/hsf.1618Abstract
In this case report, we present the delayed diagnosis of an atypical partial anomalous pulmonary venous connection, which was initially misdiagnosed as primary pulmonary arterial hypertension. It was difficult to make a conclusive diagnosis using transthoracic echocardiography (TTE), because the two high right superior pulmonary veins drained into the superior vena cava and limited the shunt of patent foramen ovale. Preoperative TTE only showed right heart volume overload, pulmonary arterial hypertension, and severe tricuspid valve insufficiency. A chest CT-angiography (angio-CT) finally found the anomalous right superior pulmonary venous connection, which was further confirmed by surgery. The postoperative course was uneventful.
References
Amat F, Le Bret E, Sigal-Cinqualbre A, et al. 2011. Diagnostic accuracy of multidetector spiral computed tomography for preoperative assessment of sinus venous atrial septal defects in children. Interact Cardiovasc Thorac Surg 12:179-82.
Glaveckaite S, Lusaite K, Grabauskiene V, Valeviciene N, Laucevicius A. 2014. Delayed diagnosis of an isolated partial anomalous pulmonary venous connection. Cent Eur J Med 9:508-12.
Kottayil BP, Dharan BS, Menon S, et al. 2011. Anomalous pulmonary venous connection to superior vena cava: Warden technique. Eur J Cardiothorac Surg 39:388-91.
Sahay S, Krasuski RA, Tonelli AR. 2012. Partial anomalous pulmonary venous connection and pulmonary arterial hypertension. Respirology 17:957-63.
Seike Y, Nakamura Y, Tagusari O, Domoto S, Nakano K, Nagashima M. 2011. Partial anomalous pulmonary venous connection and partialatrioventricular septal defect in an adult: report of a case. Surg Today 41:1421-3.
Szychta W, Cerin G, Popa BA, et al. 2015. Atypical abnormal pulmonary vein drainage with atrial septal defect: surgical treatment. Echocardiography 32:1040-3.
Wang H, Guan H, Wang DW. 2014. Partial anomalous pulmonary venous connection to superior vena cava that overrides across the intact atrial septum and has bi-atrial connectionin a 75-year-old female presenting with pulmonary hypertension. BMC Cardiovasc Disord 14:149.
Warden HE, Gustafson RA, Tarnay TJ, Neal WA. 1984. An alternative method for repair of partial anomalous pulmonary venousconnection to the superior vena cava. Ann Thorac Surg 38:601-5.
