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Surgical repair of partial anomalous pulmonary venous connection shunting from left atrium to innominate vein
© Bobylev et al.; licensee BioMed Central Ltd. 2013
Received: 25 November 2012
Accepted: 12 April 2013
Published: 18 April 2013
Partial anomalous pulmonary venous connection (PAPVC) causes a left-to-right shunt from the anomalous pulmonary vein (PV) to a systemic vein. We report an uncommon adult case of PAPVC, in which the left upper PV drained into both the innominate vein and the left atrium (LA), demonstrating retrograde shunting from the LA to the innominate vein. The anomaly was surgically repaired.
Partial anomalous pulmonary venous connection (PAPVC) of the left pulmonary veins is significantly less frequent than right ones, and most commonly drained to the innominate vein. However, there are many patterns of anomalous draining, causing shunt from left atrium (LA) to systemic veins .
In the presented case, we describe an uncommon case of PAPVC of the left upper pulmonary vein, which drained both into the innominate vein and into the LA, causing left-to right shunt from LA to innominate vein. Snellen, et al.  described the patterns of anomalous pulmonary venous drainage using 52 autopsy cases and the 72 surgical cases, and showed one case of this anomaly. There are several case reports showing the similar pattern to our case [2–4]. We previously reported a case of partial anomalous pulmonary venous connection of the right upper pulmonary vein shunting from left atrium to superior vena cava , and in this case the division of the anomalous vein to the SVC was successfully done as a surgical repair. We had expected that simple ligation of the anomalous vein was enough to repair, but we needed the rerouting procedure to keep enough pathways from left upper pulmonary vein to the left atrium in the presenting case.
In summary, we reported a rare adult case of PAPVC of the left upper pulmonary vein, which flow both into the innominate vein and the left atrium, requiring surgical rerouting of the distal end of the connecting vein to the left atrial appendage.
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
We acknowledge the support by the German Research Foundation (Deutsche Forschungsgemeinschaft).
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