Purpose
During the first eight weeks of fetal development, the lungs drain to the systemic veins, and the common primitive pulmonary vein originates from the dorsal wall of the left atrium (LA). When the pulmonary splanchnic plexus fuses with the primitive pulmonary vein, its communication with the systemic veins is obliterated. Then, the common pulmonary vein is incorporated into the LA, giving rise to four separate pulmonary veins (PV) (1,2). Abnormality of the embryological PV development can lead to abnormalities in the diameter, number, drainage or...
Methods and Materials
We retrospectively reviewed the reports of 509 patients who underwent a routine cardiac CTA for the follow-up of their CHD at our institution since 2007, and searched for the absence, stenosis or occlusion of a PV. Eight cases were identified after excluding patients with a partial anomalous pulmonary venous return.
For each patient the available clinical information was collected to identify the type of CHD, history of surgery and the surgical technique used, and the results of previous imaging tests.
Stored DICOM images of these...
Results
The CTA report of eight patients (2%) met the previously described criteria: an abnormality in the drainage of a single PV without partial anomalous pulmonary venous return. Prior surgery for congenital heart disease repair had been performed in all patients (Full description of pathology and surgical technique in Table 1).
The abnormality of the PV was classified in three types:
Agenesia: no vascular structure directly connecting the involved pulmonary lobe to the LA (2, 4). It was found in two patients (25%) with a history...
Conclusion
We present the largest series, to our knowledge, of congenital heart disease patients with impaired pulmonary venous drainage and pulmonary venovenous connections, as well as the first CT description of plexiform pulmonary venous connections.
Cardiac CTA allowed the correct diagnosis of this rare condition, which was either not detected or wrongly diagnosed by other cardiac imaging techniques.
Knowledge of these anomalous connections is important so that they are not confused with partial anomalous pulmonary venous return or misdiagnosed as other pathological conditions such as arteriovenous...
Personal Information
Department of Radiology
Hospital Universitari Vall d'Hebron
Passeig de la Vall d'Hebron 119-129, 08035, Barcelona, Spain
[email protected]
References
Jujo T, Tanabe N, Sugiura T, Naito A, Shigeta A, Kitazono-Saitoh M, et al. Importance of carefully interpreting computed tomography images to detect partial anomalous pulmonary venous return. Respir Investig [Internet]. 2016;54(1):69–74. Available from: http://dx.doi.org/10.1016/j.resinv.2015.08.008
Porres DV, Morenza OP, Pallisa E, Roque A, Andreu J, Martínez M. Learning from the pulmonary veins. RadioGraphics. 2013;33(4):999–1023.
Rodrigues MA, Ritchie G, Murchison JT. Incidental meandering right pulmonary vein, literature review and proposed nomenclature revision. World J Radiol. 2013;5(5):215–2019.
Murillo H, Cutalo MJ, Jones RP, Lane MJ, Fleischmann D,...