Percutaneous treatment of partial anomalous pulmonary venous connection with dual drainage. How would I approach it?

Abstract

HOW WOULD I APPROACH IT? Authors present here an incidental finding of an unusual yet interesting case of a partial anomalous pulmonary venous connection (PAPVC) in a 56-year-old man after a study of moderate exertional dyspnea and angina. PAPVC is a congenital malformation that can be associated with interatrial septum defects (it has been reported in 10% to 15% of the cases) or happen in isolation. It can be unilateral or bilateral. If found on the right side, the PAPVC often drains into the superior vena cava (sometimes directly into the right atrium or the inferior vena cava), and its association with sinus venosus interatrial communication is a common finding. If on the left side, the left upper pulmonary vein (LUPV) often drains directly into the left innominate vein through an anomalous vertical vein (VV). The presence of 1 bilateral PAPVC is a rarer finding. In many patients the diagnosis of this entity is merely incidental since patients are often asymptomatic especially for the lack of other congenital cardiac defects. Based on the degree of left-right shunt, the right cavities can be dilated and even in some cases, pulmonary hypertension due to vascular pulmonary vascular bed remodeling can occur. Traditionally, the management of...