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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 2, March/April 2018
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In our case, even though four pulmonary veins drained into
the left atrium, one accessory pulmonary vein on the right side
had dual drainage into the superior vena cava via the vertical vein
and into the left atrium via a tortuous connection to the right
inferior pulmonary vein. Also there was anomalous connection
of the left superior pulmonary vein into the vertical vein.
Our case is unique where anomalous drainage fromboth upper
lobe lungs contributed to approximately 66% of the pulmonary
blood flow and needed to be corrected surgically. Multi-detector
computed tomography proved crucial for accurate identification.
To our knowledge there are no published reports with a similar
condition.
Conclusion
Echocardiography is the initial imaging technique of choice
but it is sub-optimal in the complete evaluation of complex
pulmonary venous anomalies. Multi-detector computed
tomography provides very rapid, safe imaging that may obviate
the need for sedation. Axial and three-dimensional reconstructed
images accurately depict the anomalous pulmonary venous
structures prior to further surgical management.
The authors acknowledge Rajesh Jayakumar and Haya Y Al Amer for recon-
structing the CT and line images.
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