Partial Anomalous Pulmonary Venous Return in Adults

Chaaban, Nourhan; Shah, Hamna; Joshi, Akash; Kshatriya, Shilpa

doi:10.7759/cureus.26777

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Fixed changes in the precapillary pulmonary vasculature are characteristic features of pulmonary vascular disease. Increasing right heart afterload may lead to shunt reversal (change to the right-to-left shunt), also known as Eisenmenger´s syndrome [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

An Unexpected Diagnostic Twist in an Elderly Patient: No Heart Failure With Preserved Ejection Fraction

Vysočanský,

Luknár,

Lesný

et al. 2024

Cureus

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Heart failure with preserved ejection fraction (HFpEF) is considered to be the dominant cause of dyspnea and pulmonary hypertension (PH) in elderly patients with preserved left ventricular systolic function and cardiovascular comorbidities. However, it is important to keep in mind that left ventricular diastolic dysfunction is not the only possible cause of PH in cases of late-onset clinical manifestation. A multiparametric approach is essential for accurate diagnosis and therapeutic decision-making. A 74-year-old patient was admitted due to progressive dyspnea and suspicion of PH. Given the patient's risk profile, HFpEF and concomitant post-capillary PH were anticipated. Despite negative findings on CT angiography and transesophageal echocardiography, right heart catheterization was performed, revealing discrepant oxygen saturations in the superior vena cava and right atrium. A partial anomalous pulmonary venous return and an atrial septal defect were identified through cardiac magnetic resonance imaging.

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Section: Introductionmentioning

confidence: 99%

An Unexpected Diagnostic Twist in an Elderly Patient: No Heart Failure With Preserved Ejection Fraction

Vysočanský,

Luknár,

Lesný

et al. 2024

Cureus

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“…Despite a promising record with ample data exhibiting improved overall outcomes for patients, PCI continues to be limited by significantly lower success rates, higher required revision rates, and higher complication rates in patients with abnormal anatomy and congenital anatomical variations [3]. Partial anomalous pulmonary venous return (PAPVR) is a congenital heart defect that is typically identified and corrected in the pediatric population; however, the incidence of PAPVR in the adult population is largely unknown but estimated to be roughly between 0.5% and 0.7% of the population [4,5]. PAPVR refers to conditions in which there is some degree of aberrant pulmonary venous drainage to any location other than the LA.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Acute Cardiac Tamponade as a Result of Intracardiac Perforation Requiring Emergency Continuous Pericardiocentesis and Open Sternotomy: A Case Report and Literature Review of a Rare but Fatal Complication

Russo,

Harrison,

Harry

et al. 2024

Cureus

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Intraoperative acute cardiac tamponade associated with iatrogenic intracardiac perforation from percutaneous interventional cardiac procedures is a rare but potentially catastrophic complication. We report a case of intraoperative acute hemopericardium caused by a left atrial (LA) perforation resulting in cardiac tamponade in a patient undergoing a baffling procedure for the correction of two anomalous pulmonary veins draining into her superior vena cava (SVC) that required continuous pericardiocentesis with autologous blood transfusion via the femoral vein and an emergency intraoperative transfer from the interventional cardiology cath lab to the cardiac operating room for an open sternotomy and primary repair. An 86-year-old female with known right-ventricular (RV) failure with preserved ejection fraction (left ventricular ejection fraction (LVEF): 50-55% on transesophageal echocardiography (TEE) one week prior) and atrial fibrillation was admitted for her third heat failure exacerbation in two months despite being adherent to her aggressive diuresis medication regimen. Upon her readmission and due to her symptomatic and seemingly refractory heart failure, the patient underwent a cardiac computer tomography (CT) with 3D reconstruction that showed previously undiagnosed partial anomalous pulmonary venous return (PAPVR) of two of her four pulmonary veins aberrantly draining into the SVC. This anatomic pathology was deemed to be the likely etiology of her repeated episodes of recurring heart failure exacerbations, shortness of breath, peripheral edema, and fatigue. The patient was counseled and consented to a percutaneous baffle of the two anomalous veins to redirect more of the returning pulmonary venous blood away from the SVC and to the LA. While under general endotracheal anesthesia (GETA) with a TEE in place during the procedure, the patient suddenly developed acute hypotension, tachycardia, and a reduction in expired carbon dioxide (EtCO 2 ) was noted quickly followed by evidence of a rapidly accumulating hemopericardium on TEE.Cardiothoracic surgery was urgently consulted to the interventional cardiology cath lab while the patient underwent an emergency pericardiocentesis that momentarily alleviated her hemodynamic instability, cardiac tamponade physiology, and deteriorating overall clinical picture. While performing continuous pericardiocentesis with autologous return of the aspirated blood via femoral venous access the patient was urgently transported to the cardiac operating room and prepped for emergency sternotomy for primary repair of the LA. Following primary repair via sternotomy, multiple drains were placed and the thoracic cavity was closed with wires. The patient was immediately transported to the surgical intensive care unit (SICU) intubated, mechanically ventilated, and sedated. During this time, the patient progressively required additional vasoactive and inotropic agents to support her mean arterial pressure (MAP), and following a multidisciplinary discussion with the patient's family regardi...

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Conexión venosa pulmonar anómala parcial supra cardiaca. Por qué la imagen ecocardiográfica supraesternal es obligatoria

Romero Rivera,

Vázquez Antona,

Pignatelli

2023

Rev Ecocar Pract (RETIC)

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Diferente de la forma de conexión total, la conexión venosa anómala parcial supracardíaca puede ser asintomática durante un tiempo y ser diagnosticada de forma accidental durante un examen ecocardiográfico de rutina. En estos casos, la realización de la aproximación supraesternal en el estudio ecocardiográfico es fundamental para el diagnóstico y debe ser realizado en todos los pacientes independientemente de la edad, principalmente cuando sea observada dilatación de las cámaras derechas sin comunicación interauricular.

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Partial Anomalous Pulmonary Venous Return in Adults

Cited by 3 publications

References 7 publications

An Unexpected Diagnostic Twist in an Elderly Patient: No Heart Failure With Preserved Ejection Fraction

An Unexpected Diagnostic Twist in an Elderly Patient: No Heart Failure With Preserved Ejection Fraction

Intraoperative Acute Cardiac Tamponade as a Result of Intracardiac Perforation Requiring Emergency Continuous Pericardiocentesis and Open Sternotomy: A Case Report and Literature Review of a Rare but Fatal Complication

Conexión venosa pulmonar anómala parcial supra cardiaca. Por qué la imagen ecocardiográfica supraesternal es obligatoria

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