Eur J Cardiothorac Surg 2003;23:1052
© 2003 Elsevier Science NL
Images in cardio-thoracic surgery |
‘Star-like’ configuration of the pulmonary veins in a case of total anomalous pulmonary venous drainage
Massimo Chessaa*,
Mariella Lucentea,
Alessandro Giambertib,
Mario Carminatia
a Pediatric Cardiology Department, Istituto Policlinico San Donato (IPSD), San Donato Milanese, Italy
b Pediatric Cardiac Surgery Department, Istituto Policlinico San Donato (IPSD), San Donato Milanese, Italy
Received 12 November 2002;
received in revised form 12 February 2003;
accepted 17 February 2003.
* Corresponding author. Tel.: +39-02-5277-4328; fax: +39-02-5277-4459
e-mail: massimo.chessa{at}lycos.com
Key Words: Pulmonary vein • Hypoxemia • Cardiac catheterization
A newborn who presented with pulmonary oedema and ingravescent hypoxemia underwent a cardiac catheterization that showed univentricular heart, complete AV canal and total anomalous pulmonary venous drainage. The ‘star-like’ configuration of the pulmonary veins was an interesting but unexpected finding (Figs. 1 and 2) . The patient underwent successful surgical repair. In deep hypothermia and circulatory arrest we performed a side-by-side anastomosis between the posterior wall of the left atrium and the vertical vein; a complete atrioseptectomy was also performed. After the weaning of cardiopulmonary bypass and modified ultrafiltration, a pulmonary artery banding was done. The patient is at present waiting for a bi-directional cavo-pulmonary anastomosis. We present this case because of that peculiar angiographic picture.
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Fig. 1. Through the superior vena cava on the left site of descending aorta, a catheter was positioned into the azygos vein; a selective angiographic injection showed a nicely tortuous and elongated venous channel (vertical vein) draining the pulmonary veins (‘star-like’ configuration) into the azygos vein. VV, vertical vein; RVP, right pulmonary veins; LPV, left pulmonary veins.
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