Anteroposterior Pulmonary Venous Anatomy

Abstract

We have encountered a hitherto undescribed anatomical variant of pulmonary vein anatomy in hearts with d-transposition or congenitally corrected transposition of the great arteries. In this variant, the inferior right pulmonary vein lies posterior rather than inferior to the superior right pulmonary vein. This variant of pulmonary vein anatomy may predispose to the development of pulmonary venous pathway obstruction following a Senning operation, since it is difficult to open the pulmonary veins in a way that ensures a wide-open pulmonary venous pathway to the atrioventricular valve of the systemic ventricle. A method of neutralizing this effect is described, with medium-term results.