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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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References

1.Delisle, G, Ando, M, Calder, AL, Zuberbuhler, JR, Rochenmacher, S, Aldey, LL, Mangini, O, van Praagh, S, van Praagh, R. Total anomalous pulmonary venous connection: report of 93 autopsied cases with emphasis on diagnostic and surgical considerations. Am Heart J 1976; 91: 99115.CrossRefGoogle ScholarPubMed
2.Goswami, KC, Shrivastava, S, Saxena, A, Dev, V. Echocardiographic diagnosis of total anomalous pulmonary venous connection. Am Heart J 1993; 126: 433440.CrossRefGoogle ScholarPubMed
3.Sahn, DJ, Alien, HD, Lange, LW, Goldberg, SJ. Cross sectional echocardiographic diagnosis of the sites of total anomalous venous drainage. Circulation 1979; 60: 13171325.Google Scholar
4.Lupinetti, F, Kulik, TJ, Beekman, RH, Crowley, DC, Bove, EL. Correction of total anomalous pulmonary venous connection in infancy. J Thorac Cardiovasc Surg 1993; 106: 880885.CrossRefGoogle ScholarPubMed
5.Van der Velde, ME, Parness, IA, Colan, SD. Two-dimensional echocardiography in the pre and postoperative management of totally anomalous pulmonary venous connection. J Am Cell Cardiol 1991; 18: 17461751.CrossRefGoogle ScholarPubMed
6.Smallhorn, JF, Freedom, RM. Pulsed Doppler echocardiography in the preoperative evaluation of the total anomalous venous connection. J Am Cell Cardiol 1986: 14131420CrossRefGoogle Scholar
7.Snider, RA, Silverman, NH, Turley, K, Ebert, PA. Evaluation of infradiaphragmatic total anomalous pulmonary venous connection with two dimensional echocardiography. Circulation 1982; 66: 11291132.Google Scholar
8.Huhta, JC, Gutgesell, HP, Nihill, MR. Cross sectional echocardiographic diagnosis of total anomalous pulmonary venous connection. Br Heart J 1985; 53: 525534.CrossRefGoogle ScholarPubMed
9.Chin, AJ, Sanders, SP, Sherman, F, Lang, P, Norwood, WI, Castaneda, AR. Accuracy of subcostal two dimensional echocardiography in prospective diagnosis of total anomalous pulmonary venous connection. Am Heart J. 1987; 113: 11531159.Google Scholar
10.Narayanswami, S, Walsh, K. Diagnosis of total anomalous pulmonary venous drainage by Doppler-color flow imaging. J Am Coll Cardiol 1992; 19: 15771582.Google Scholar
11.Smallhorn, JF, Sutherland, GR, Tommasini, G, Hunter, S, Anderson, RH, MacCartney, FJ. Assessment of total anomalous venous connection with two-dimensional echocardiography. Br Heart J 1981; 46: 613623.CrossRefGoogle ScholarPubMed
12.Corno, A, Giamberti, A, Carotti, A, Giannico, S, Marino, B, Marcelletti, C. Total anomalous pulmonary venous connection: surgical repair with a double-patch technique. Ann Thorac Surg 1990; 49: 492494.Google Scholar
13.Carminati, M, Bonhoeffer, P, Borghi, A, Al Fagih, M, Joseph, Mc, Miller, GA, Shinebourne, JA. Ritorno venoso polmonare anom-alo totale: è possibile la correzione chirurgica sulla base della soli diagnosi ecocardiografica? G Ital Cardiol 1990; 20: 419424.Google Scholar
14.Van Hare, GF, Schmidt, KG, Cassidy, SC, Gooding, CA, Silverman, NH. Color Doppler flow mapping in the ultrasound diagnosis of total anomalous pulmonary venous connection. J Am Soc Echo 1988; 1: 341347.CrossRefGoogle ScholarPubMed
15.Lincoln, CR, Rigby, ML, Mercanti, C, Preda, L, Valsecchi, O, Festa, P, Crupi, G, Tiraboschi, R. Surgical risk factors in total anomalous pulmonary venous connection. Am J Cardiol 1988; 61: 608611.CrossRefGoogle ScholarPubMed