Total Anomalous Pulmonary Venous Connection　― Least Common Type Delineated on Computed Tomography ―

The mixed type of total anomalous pulmonary venous connection (TAPVC) is a rare variant occurring in 5–7% of all patients.¹ Specifically, “dual” or “double” drainage via a common venous confluence (i.e., a common venous confluence connected to 2 anomalous sites) is even rarer.² A patient who underwent TAPVC repair had unobstructed drainage of all 4 pulmonary veins to both left vertical vein and coronary sinus (Figure). In these cases, when the anatomy does not fit the Darling classification, precise, preoperative evaluation using computed tomography along with echocardiography³ is effective to confirm the pulmonary venous anatomy in TAPVC.

Figure.

Disclosures

The authors declare no conflicts of interest.

References

• 1.   Seale AN, Uemura H, Webber SA, Partridge J, Roughton M. Total anomalous pulmonary venous connection: Morphology and outcome from an international population-based study. Circulation 2010; 122: 2718–2726.
• 2.   Imoto Y, Kado H, Asou T, Shiokawa Y, Tominaga R, Yasui H. Mixed type of total anomalous pulmonary venous connection. Ann Thorac Surg 1998; 66: 1394–1397.
• 3.   Jiang L, Xie LJ, Yang ZG, Shi K, Xu HY, Li R, et al. Preoperative evaluation of anomalous pulmonary venous connection using dual-source computed tomography: Comparison with echocardiography. Eur J Radiol 2017; 94: 107–114.