Partial anomalous pulmonary venous return and atrial septal defect in adult patients detected with 128-slice multidetector computed tomography

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Abstract

The present series describes a group of adults with left-to-right shunts including partial anomalous pulmonary venous return (PAPVR) and/or an atrial septal defect (ASD) evaluated with ECG-gated 128-slice multidetector computed tomography (MDCT). PAPVR is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium. PAPVR involving the right upper pulmonary vein can be associated with a sinus venosus ASD. The presence, course, number of anomalous veins and associated cardiovascular defects can be reliably observed by 128-slice MDCT angiography.

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Diagnosis and Management of Partial Anomalous Pulmonary Venous Connection

Takayuki Hijii, Junichiro Fukushige, Toshiro Hara (1998)

Medical records, angiograms and operative records of 28 patients with partial anomalous pulmonary venous connection (PAPVC) were reviewed. Twenty patients had one anomalous pulmonary vein (APV), and 8 had more than two APVs. Twenty-five patients (89%) had APVs originating from the right lung, 2 (7%) from the left lung and 1 (4%) from both lungs. In the 25 patients with APVs originating from the right lung, 9 had APVs draining into the superior vena cava (SVC), 13 into the right atrium (RA), 1 into the inferior vena cava (IVC) and 2 into both the SVC and RA. In the 2 patients with APVs originating from the left lung, 1 had APVs draining into the RA, and the other had APVs draining into the innominate vein. The patient with APVs originating from both lungs had connection to the IVC. Twenty-three patients (82%) had additional cardiovascular defects. Surgery was performed in 13 patients who had pulmonary/systemic flow ratios greater than 2.0. The patients have done well after surgery. In 7 patients, we were unable to accurately determine the number or sites of drainage of APVs prior to surgery. We conclude that selective pulmonary angiography is indispensable for the accurate diagnosis of PAPVC.

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Cardiac CT and CT coronary angiography: technology and application.

Claire L. Davies, David Roberts, Jeroen J. Bax (2008)

Multislice computed tomography (MSCT) is an additional potential tool for the assessment of coronary artery disease. It can provide information about stenoses in coronary arteries and coronary artery bypass grafts, ventricular size and function, cardiac structure and masses, pulmonary vein anatomy, myocardial perfusion and coronary artery plaque. In this review the recent developments in CT technology that have made cardiac imaging possible are examined and the benefits of the latest 64-slice and dual-source CT scanners explained. Information on how to perform cardiac CT and evidence for its various clinical applications are given. Problems and limitations of cardiac CT and the radiation dose are discussed. Future developments and the likely impact of this rapidly evolving technique on clinical cardiology are considered.

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Ultrafast three-dimensional contrast-enhanced magnetic resonance angiography and imaging in the diagnosis of partial anomalous pulmonary venous drainage.

Victor Ferrari, Craig Scott, George A Holland … (2001)

The purpose of our study was to evaluate patients with suspected anomalous pulmonary veins (APVs) and atrial septal defects (ASDs) using fast cine magnetic resonance imaging (MRI) and ultrafast three-dimensional magnetic resonance angiography (MRA). Precise anatomic definition of anomalous pulmonary and systemic veins, and the atrial septum are prerequisites for surgical correction of ASDs. Cardiac catheterization and transesophageal echocardiography (TEE) are currently used to diagnose APVs, but did not provide complete information in our patients. Twenty consecutive patients with suspected APVs were studied by MRA after inconclusive assessment by catheterization, TEE or both. The MRI images were acquired with a fast cine sequence and a novel ultrafast three-dimensional sequence before and after contrast injection. Partial anomalous pulmonary venous drainage was demonstrated in 16 of 20 patients and was excluded in four patients. Magnetic resonance imaging correctly diagnosed APVs and ASDs in all patients (100%) who underwent surgery. For the diagnosis of APVs, the MRI and catheterization results agreed in 74% of patients and the MRI and TEE agreed in 75% of patients. For ASDs, MRI agreed with catheterization and TEE in 53% and 83% of patients, respectively. Fast cine MRI with three-dimensional contrast-enhanced MRA provides rapid and comprehensive anatomic definition of APVs and ASDs in patients with adult congenital heart disease in a single examination.

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Journal

Journal ID (nlm-ta): J Cardiothorac Surg

Title: Journal of Cardiothoracic Surgery

Publisher: BioMed Central

ISSN (Electronic): 1749-8090

Publication date Collection: 2011

Publication date (Electronic): 30 September 2011

Volume: 6

Page: 126

Affiliations

[1 ]Department of Radiology, University of Helsinki and HUS Radiology (Medical Imaging Center), Haartmaninkatu 4, Helsinki, 00029 HUS, Finland

[2 ]Department of Cardiology, Helsinki University Central Hospital, Haartmaninkatu 4, Helsinki, 00029 HUS, Finland

[3 ]Department of Radiology, University of Helsinki and HUS Radiology (Medical Imaging Center), Haartmaninkatu 4, Helsinki, 00029 HUS, Finland

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Publisher ID: 1749-8090-6-126

DOI: 10.1186/1749-8090-6-126

PMC ID: 3201903

PubMed ID: 21961903

SO-VID: 02955c5e-ec06-434a-83cb-2d3d1fb20753

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Partial anomalous pulmonary venous return and atrial septal defect in adult patients detected with 128-slice multidetector computed tomography

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Most cited references 10

Diagnosis and Management of Partial Anomalous Pulmonary Venous Connection

Cardiac CT and CT coronary angiography: technology and application.

Ultrafast three-dimensional contrast-enhanced magnetic resonance angiography and imaging in the diagnosis of partial anomalous pulmonary venous drainage.

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