Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium.
BACKGROUND
A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium.


METHODS
We retrospectively studied such patients in 5 institutions.


RESULTS
Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n=2) and secundum atrial septal defects (n=3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n=2), secundum atrial septal closure (n=2), left upper pulmonary vein stenosis stenting (n=1), and coarctation stenting (n=1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p=0.056).


CONCLUSIONS
In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients.
Cardiologie pédiatrique et congénitale, Hôpital de la Timone-Enfants, Marseille, France.
Debora
D
Luciano
Daniela
D
Laux
Younes
Y
Boudjemline
Sébastien
S
Hascoët
Jean-René
JR
Lusson
Clio
C
Sorensen
Caroline
C
Ovaert
Bernard
B
Kreitmann
Richard
R
Van Praagh
Alain
A
Fraisse
D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006328:Cardiac Catheterization; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation; D011667:Pulmonary Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D012587:Scimitar Syndrome / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000002:abnormalities / Q000000981:diagnostic imaging; D055815:Young Adult
Congenital heart disease; Intervention; Pulmonary vein