Acquired unilateral pulmonary vein atresia in a 3-year-old boy

Abstract

While unilateral pulmonary venous atresia (UPVA) most commonly presents as an extremely rare late embryological defect resulting in complete occlusion or absence of the PV pathway, it may also be an acquired pathology. We present a 3-year-old boy who presented with mild respiratory distress. Neonatal echocardiographic investigations revealed normal mediastinal anatomy and pulmonary vasculature with a bicuspid aortic valve. However, follow-up Doppler investigation revealed a pulmonary artery size difference with minimal forward flow and reverse flow during diastole. Absence of the left pulmonary veins and the presence of collaterals draining to the innominate vein confirmed the diagnosis of acquired UPVA. Our case represents the first case of acquired UPVA in conjunction with a normally functioning bicuspid aortic valve. The Doppler flow patterns discussed might be of significant interest to pediatricians, cardiologists and imaging specialists. These findings suggest that acquired UPVA should be considered in the differential diagnosis of such patients when radiographic and echocardiographic findings may rule out other more common diagnoses. While the management of such a condition remains unclear and conservative management was agreed upon for our patient, the vulnerability of such cases warrants timely diagnosis and routine monitoring.

Isolated unilateral pulmonary vein atresia with hemoptysis in a child

“…Overall, the prognosis of unilateral PVA was still guarded, with an approximately 50% mortality rates in untreated patients, [ 11 ] so early and accurate diagnosis is quite pivotal and essential before pulmonary hypertension or massive pulmonary hemorrhage occurred. Being aware of the possibility of unilateral PVA and avoidance of misdiagnosis of idiopathic pulmonary hemosiderosis when confronted with childhood patients presenting with hemoptysis, is of great importance.…”

Right Sub-axillary Incision for Right Pulmonary Vein Atresia in a Child: A Case Report and Literature Review

“…However, some scholars believe that UPVA is a secondary vascular occlusion change, and the causes of secondary UPVA include postoperative complications of congenital heart disease [5] , mediastinal tumor, pericardial or mediastinal infection, cardiac tumor, and thrombosis. Mohammed Firdouse et al [6] reported a case where a child had a normal pulmonary artery and pulmonary vein before examination, but UPVA was found during follow-up. The patient had not undergone surgery because there were no obvious clinical manifestations.…”