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Intrapulmonary Right Vertical Vein in Supracardiac Total Anomalous Pulmonary Venous Connection with Right Isomerism

2021; Radiological Society of North America; Volume: 3; Issue: 2 Linguagem: Inglês

10.1148/ryct.2021200601

2638-6135

Rengarajan Rajagopal, Ritu Agarwal, Nirmala Royal, Meenu Bagarhatta,

Congenital Diaphragmatic Hernia Studies

HomeRadiology: Cardiothoracic ImagingVol. 3, No. 2 PreviousNext Images in Cardiothoracic ImagingFree AccessCardiac ImagingIntrapulmonary Right Vertical Vein in Supracardiac Total Anomalous Pulmonary Venous Connection with Right IsomerismRengarajan Rajagopal , Ritu Agarwal, Nirmala Royal, Meenu BagarhattaRengarajan Rajagopal , Ritu Agarwal, Nirmala Royal, Meenu BagarhattaAuthor AffiliationsFrom the Department of Radiodiagnosis, SMS Medical College & Attached Hospitals, Jaipur, Rajasthan, India 302004.Address correspondence to R.R. (e-mail: [email protected]).Rengarajan Rajagopal Ritu AgarwalNirmala RoyalMeenu BagarhattaPublished Online:Apr 8 2021https://doi.org/10.1148/ryct.2021200601MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In A 4-month-old female infant with cyanosis, excessive sweating, and failure to thrive was referred for CT, which showed bilateral trilobed lungs, midline liver, and asplenia consistent with right isomerism. Complex intracardiac defects were seen: dextrocardia, discordant atrioventricular connections, common atrioventricular valve, double outlet right ventricle, and pulmonary stenosis. Left-sided pulmonary veins formed a common vein that crossed over horizontally to the right hemithorax (Fig 1, A and B). This vein had a vertical course within the right lung receiving all right-sided pulmonary veins to drain into the right brachiocephalic vein. Intrapulmonary course of vertical veins in patients with supracardiac total anomalous pulmonary venous connection is an uncommon abnormality. Obstruction of this drainage has been reported in about one-half of patients (1). Cardiac CT accurately depicts the intrapulmonary course of vertical veins (Figs 1, A and B, and 2), which is difficult to visualize at echocardiography, which is usually the initial imaging modality in children with congenital heart defects.Figure 1: A, Anterior, B, right anterior oblique, C, right lateral, and, D, posterior view volume-rendered images, with aorta and pulmonary arteries removed, show the common vein (thick arrows) crossing over horizontally to the right side having a vertical intrapulmonary course to drain into the right brachiocephalic vein (thin arrows).Figure 1:Download as PowerPointOpen in Image Viewer Figure 2: A, Coronal and, B, axial lung window CT angiography images show the common vein (arrow) crossing over to the right side with a vertical intrapulmonary course to drain into the right brachiocephalic vein. The common vein is seen to be surrounded completely by lung parenchyma.Figure 2:Download as PowerPointOpen in Image Viewer Disclosures of Conflicts of Interest: R.R. disclosed no relevant relationships. R.A. disclosed no relevant relationships. N.R. disclosed no relevant relationships. M.B. disclosed no relevant relationships.Keywords: CT-Angiography, Cardiac, Congenital, Pediatrics, Pulmonary Veins Authors declared no funding for this work. Reference1. Campanale CM, Banka P, Sanders SP. Anomalous Pulmonary Venous Connection With an Intraparenchymal Course. World J Pediatr Congenit Heart Surg 2017;8(2):210–214. Crossref, Medline, Google ScholarArticle HistoryReceived: Nov 30 2020Revision received: Jan 4 2021Revision requested: Jan 6 2021Accepted: Jan 20 2021Published online: Apr 08 2021 FiguresReferencesRelatedDetailsRecommended Articles Comprehensive Cross-sectional Imaging of the Pulmonary VeinsRadioGraphics2017Volume: 37Issue: 7pp. 1928-1954Superior Vena Cava Stenosis Manifesting with Brain Abscess 2 Decades after Atrial Septal Defect RepairRadiology: Cardiothoracic Imaging2021Volume: 3Issue: 2CT Appearance of Pulmonary Arteriovenous Malformations and MimicsRadioGraphics2022Volume: 42Issue: 1pp. 56-68Perfusion Scintigraphy in Diagnosis and Management of Thromboembolic Pulmonary HypertensionRadioGraphics2019Volume: 39Issue: 1pp. 169-185Vascular Anomalies of the Pediatric LiverRadioGraphics2019Volume: 39Issue: 3pp. 842-856See More RSNA Education Exhibits Pediatric Pre-op CTA of Supra-Cardiac TAPVD: Melbourne Royal Children’s Hospital ExperienceDigital Posters2018Imaging of Congenital and Acquired Thoracic Venous Anomalies: What the Radiologist Needs to KnowDigital Posters2018Bubbling Over: What Radiologists Should Look for Following a Positive Bubble StudyDigital Posters2018 RSNA Case Collection Infra-diaphragmatic Total Anomalous Pulmonary Venous ReturnRSNA Case Collection2021Intrapulmonary Venous CollateralRSNA Case Collection2022Right upper PAPVR and persistent left SVCRSNA Case Collection2020 Vol. 3, No. 2 Metrics Altmetric Score PDF download