A Case of Total Anomalous Pulmonary Venous Connection with Two Vertical Veins Draining to the Infracardiac Level

Abstract

Infracardiac type total anomalous pulmonary venous connection (TAPVC) was diagnosed in a 1-day-old boy. We performed emergency total correction on day 1 and found 2 vertical veins draining to the infracardiac level separately.Each vertical vein was rerouted to the left atrium. On the first postoperative day, an extracorporeal membrane oxygenation was required because of respiratory failure. He died due to cerebral hemorrhage on the 5th day after the operation. Macroscopic findings showed the right sided vertical vein draining to the IVC, and the left sided one to the confluence of the hepatic vein and ductus venosus. Microscopic findings of the lung revealed markedly dilated lymphatics which was suspected as the cause of respiratory failure. Although cases with 2 separate vertical veins are very rare, the precise anatomy of PV return has to be checked intraoperatively when the preoperative identification has not been established.