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Echocardiographic diagnosis of totally anomalous pulmonary venous connection to the azygos vein

Published online by Cambridge University Press:  19 August 2008

Anna Maria Musolino
Affiliation:
Department of Pediatric Cardiology, Ospedale ‘Bambino Gesù’, Rome, Italy
Giuseppe Santoro
Affiliation:
Department of Pediatric Cardiology, Ospedale ‘Bambino Gesù’, Rome, Italy
Bruno Marino
Affiliation:
Department of Pediatric Cardiology, Ospedale ‘Bambino Gesù’, Rome, Italy
Roberto Formigari
Affiliation:
Department of Pediatric Cardiology, Ospedale ‘Bambino Gesù’, Rome, Italy
Paolo Guccione
Affiliation:
Department of Pediatric Cardiology, Ospedale ‘Bambino Gesù’, Rome, Italy
Luciano Pasquini*
Affiliation:
Department of Pediatric Cardiology, Ospedale ‘Bambino Gesù’, Rome, Italy
*
Luciano Pasquini, MD, FESC, Department of Pediatric Cardiology, Ospedale ‘Bambino Gesù’, P.zza S. Onofrio, 4, 1-00165, Rome, Italy. Tel: 39 6 68592333; Fax: 39 6 68592454

Abstract

Totally anomalous pulmonary venous connection to the azygos vein is a rare congenital heart malformation in which all the pulmonary venous blood returns anomalously to the azygos vein. Among 111 consecutive patients with totally anomalous pulmonary venous connection undergoing surgical correction at our institution between June 1982 and September 1997, this malformation was present in seven cases. By echocardiography, using a subxyphoid short-axis view at the atrial level and a modified suprasternal sagittal view, the malformation was diagnosed when the pulmonary venous confluence was traced posteriorly and superiorly relative to the right pulmonary artery and right bronchus, finally reaching reach the superior caval vein. Totally anomalous pulmonary venous connection to the azygos vein was misdiagnosed in the first two patients, both by echocardiography and angiocardiography. In the subsequent five patients, a precise diagnosis was obtained by echocardiography. Echocardiography, therefore, can be considered an accurate diagnostic tool permitting recognition of totally anomalous pulmonary venous connection to the azygos vein, and permitting corrective surgery without recourse to catheterization and angiography.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1999

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