Clinical and diagnostic features of partially anomalous pulmonary venous connection in an adult female patient: a case report and review of the literature.
TL;DR: CT scan and MRI of the thorax were diagnostic for an aberrant pulmonary venous connection between the left lower lobe pulmonary vein and the left brachiocephalic vein without atrial septal defect.
Abstract: A 40-year-old woman presented with dyspnoea, chest pain and fatigue. Her medical history was unremarkable. An early systolic ejection murmur was heard in the 3D left inter-costal space. Chest X-ray revealed normal cardiothoracic ratio with an anomalous vessel adjacent to the left pulmonary hilum. Echocardiography and exercise tolerance test were normal. Right heart catheterisation revealed normal pulmonary pressures with normal cardiac output. CT scan and MRI of the thorax were diagnostic for an aberrant pulmonary venous connection between the left lower lobe pulmonary vein and the left brachiocephalic vein without atrial septal defect. She was treated conservatively and remained well.
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TL;DR: The roots of cardiac computed tomography and its main achievements over the past 30 years are briefly looked back to.
Abstract: 2013 is a remarkable year in cardiovascular medicine from a historical point of view. It can be considered a crown year for non-invasive clinical cardiovascular imaging as we can look back on 60 years of echocardiography, 40 years of nuclear cardiology, 30 years of cardiovascular magnetic resonance imaging, and 30 years of cardiac computed tomography. In previous Editor’s Comments, 60 years of echocardiography, 40 years of nuclear cardiology, and 30 years of cardiovascular magnetic resonance have been described (Parts I, II, and II) [1–3]. In this Editor’s Comment (Part IV) we will briefly look back to the roots of cardiac computed tomography and its main achievements over the past 30 years.
10 citations
Cites background from "Clinical and diagnostic features of..."
...atrial fibrillation to assess cardiac venous anatomy, and patients with valvular lesions to calculate dimensions of the aortic root or the mitral valve annulus [42–54]....
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23 Jun 2017
TL;DR: A case of young female in whom CVC placed through left internal jugular venous (IJV) route accidentally entered into a left upper pulmonary vein through partial anomalous pulmonary venous connection (PAPVC) with the left brachiocephalic vein, a unique and first of its kind report.
Abstract: Central venous catheter (CVC) is one of the most commonly placed invasive devices in critical care setup. Its placement can be associated with many technical complications like bleeding, pneumothorax, arterial puncture and infection. Furthermore technical and anatomical variations, unfavorable body habitus can lead to malpositioning of CVC within venous system even when they are placed under radiological guidance. If not addressed timely, malpositioning can be associated with poor catheter functioning and serious complications like vessel erosion, bleeding, thrombosis. Presence of congenital venous anomalies can be a rare cause of CVC malpositioning. We report a case of young female in whom CVC placed through left internal jugular venous (IJV) route accidentally entered into a left upper pulmonary vein through partial anomalous pulmonary venous connection (PAPVC) with the left brachiocephalic vein. Post insertion chest radiograph showed unusual curvilinear course of the left IJV access towards left pulmonary hilum. The diagnosis was clinched after contrast enhanced computed tomography delineated the previously undiagnosed venous anomaly in the patient. There is no report of CVC malposition into the pulmonary vein in medical literature making it unique and first of its kind. Malpositioned CVC can thus lead to revelation of asymptomatic congenital vascular anomalies in a completely unrelated clinical setting.
2 citations
Cites background from "Clinical and diagnostic features of..."
...Discussion PAPVC is a rare congenital anomaly causing left to right shunt akin to atrial septal defect [1]....
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...Clinical evaluation in symptomatic patients may reveal evidence of right ventricular hypertrophy, elevated pulmonary pressures, and signs of right heart ischemia [1]....
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TL;DR: Partial anomalous pulmonary venous return (PAPVR) is a rare congenital abnormality in which 1 to 3 of the pulmonary veins connect to the right atrium rather than the left atrium.
Abstract: Partial anomalous pulmonary venous return (PAPVR) is a rare congenital abnormality in which 1 to 3 of the pulmonary veins connect to the right atrium rather than the left atrium. In this synthesis of the literature on PAPVR of the left upper lobe, we attempt to illustrate this clinical entity using a case detected incidentally on chest computed tomography, explain the anatomical aspects of this anomaly, and summarize the reported incidence and etiology of left-sided PAPVR. Lastly, differential diagnoses, clinical relevance, and management of left-sided PAPVR are presented. The identification of this variant is important, as it may have serious consequences.
1 citations
01 Jan 2019
TL;DR: This case describes a partially anomalous pulmonary vein leads to RV dilation in a 31- year- old woman who is diagnosed with central giant cell granuloma.
Abstract: This case describes a partially anomalous pulmonary vein leads to RV dilation in a 31- year- old woman.
References
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TL;DR: The examination of serial sections of human embryos between 24 and 34 days and the use of plastic reconstructions showed that the common pulmonary vein develops as an outgrowth from the medial superior wall of the left auricle and unites with the angioblastic plexus of the developing lung bud.
Abstract: The examination of serial sections of human embryos between 24 and 34 days (3 to 11 mm) and the use of plastic reconstructions, showed that the common pulmonary vein develops as an outgrowth from the medial superior wall of the left auricle and unites with the angioblastic plexus of the developing lung bud. No evidence was found that the vein connects directly with the sinus venosus in the early stages, and later shifts in position as the atrial septum grows. Anomalous pulmonary venous drainage is classified in four main types, and theories of development are briefly discussed.
184 citations
97 citations
"Clinical and diagnostic features of..." refers background in this paper
...Persistence of the venous drainage of the lung into the systemic cardinal and umbilical vitelline systems apparently results in a variety of anomalies of pulmonary venous return [3–6]....
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TL;DR: Correction of partial anomalous pulmonary venous connection should be individualized according to the site of connection of the anomalously pulmonary veins and the location of the atrial defect to minimize undesirable postoperative sequelae often associated with other methods of repair.
90 citations
"Clinical and diagnostic features of..." refers background in this paper
...PAPVC has high physiological significance when the atrial septum is intact because only one lung is draining into the left atrium and a large left–right shunt is present leading to high pulmonary pressure and development of pulmonary hypertension [7]....
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26 Aug 1953
64 citations
"Clinical and diagnostic features of..." refers background in this paper
...Persistence of the venous drainage of the lung into the systemic cardinal and umbilical vitelline systems apparently results in a variety of anomalies of pulmonary venous return [3–6]....
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TL;DR: The presence of an rsR′ QRS pattern in this lead was most frequently associated with drainage of the anomalous pulmonary veins into the superior vena cava or right atrium, whereas a terminal S wave in thisLead was found only in those patients with an anomalous connection of the pulmonary veins to the inferior vena Cava.
Abstract: Twenty cases of partial anomalous pulmonary venous connection without an associated atrial septal defect have been reviewed in regard to clinical findings, hemodynamic and angiographic observations and surgical therapy. Of particular interest was the finding of a correlation between the QRS configuration in lead V 1 and the site of drainage of the anomalous pulmonary venous connection. The presence of an rsR′ QRS pattern in this lead was most frequently associated with drainage of the anomalous pulmonary veins into the superior vena cava or right atrium, whereas a terminal S wave in this lead was found only in those patients with an anomalous connection of the pulmonary veins to the inferior vena cava. Large left to right shunts with pulmonary-systemic flow ratios of greater than 2.0 were noted in 7 patients, all of whom had a complete anomalous connection of one lung.
55 citations
"Clinical and diagnostic features of..." refers background in this paper
...Peripheral oedema can occur in adults with cardiac failure [1]....
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...Partial anomalous pulmonary venous connection (PAPVC) is an uncommon congenital anomaly [1]....
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