We report a case of a 3‐month‐old boy transposition of great arteries, ventricular septal defect, and pulmonary stenosis where computed tomography (CT) angiography detected a “levoatriocardinal vein” connecting the left superior pulmonary vein and the left brachiocephalic vein with a preserved normal connection between the left superior pulmonary vein and left atrium. This case highlights the hemodynamic implications of a “levoatriocardinal vein” as well as the role of CT angiography in detecting such associated cardiovascular anomalies in patients with complex congenital heart defects.
We report a case of a 3-month-old girl with pulmonary atresia and intact ventricular septum where computed tomography (CT) angiography demonstrated an anomalous venous channel connecting the left brachiocephalic vein to the left atrium and all the pulmonary veins draining the left lung were seen draining individually into this channel. The case highlights the differential diagnosis of such veno-venous connections between the systemic and pulmonary venous circulations as well as the growing role of CT angiography in the understanding of these venous anomalies in the setting of complex congenital heart diseases.
Aim: To study the imaging characteristics and the associations of left atrioventricular valve atresia with patent aortic root and lateralized atrial chambers on multidetector computed tomography (CT) angiography.
Materials and Methods:We retrospectively evaluated all the CT angiography studies performed for the evaluation of various congenital heart diseases at our center from January 2014 to December 2021. Cases with left atrioventricular valve atresia and patent aortic root with lateralized atrial chambers were identified.The types of cardiovascular involvement as identifiable on CT angiography were studied and compiled.Results: A total of 38 patients with left atrioventricular valve atresia and patent aortic root were included (median age: 5 months, males: 31). A total of 89.5% had usual atrial arrangement and 10.5% had mirror imagery of atria. Normal drainage of right and left superior caval veins and inferior caval vein into systemic venous atrium was seen in 77.8%, 61.5%, and 86.6%, respectively. Anomalous pulmonary venous drainage was seen in 3 (7.9%) patients. Atrial and ventricular septal defects were the most common associations. Imperforate left atrioventricular membrane was seen in 9 (23.7%) patients and absent left atrioventricular connection in 27 (71.1%).Discordant right atrioventricular connection was seen in 5 (13.1%) patients. While a double outlet right ventricle (76.3%) was the most common ventriculoarterial connection, discordant ventriculo-arterial connection (transposition) in 4 (10.5%).Most patients had good sized pulmonary arteries. Patent arterial duct and right aortic arch were seen in 29% and 21%, respectively. Aberrant right subclavian artery was the most common arch vessel anomaly. Coronary anomalies were seen in 7 patients (19%); single coronary artery being the most common. Conclusions: Majority of the patients with left atrioventricular valve atresia and patent aortic root with lateralized atrial chambers have usual atrial arrangement, normal right atrioventricular connections and a double outlet configuration of the right ventricle. Absent left atrioventricular connection is a more common than imperforate left atrioventricular valve membrane. Atrial and ventricular septal
We report a case of 6‐week‐old boy with a mixed variety of totally anomalous pulmonary venous connection where the common channel had a dual drainage into the coronary sinus and left brachiocephalic vein respectively. The case also highlights the role of preoperative computed tomography angiography in demonstrating the exact pulmonary venous anatomy, course and identifying obstruction, when present.
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