RESUMO
Partial anomalous pulmonary venous drainage is a congenital cardiac disorder characterized by abnormal drainage of one or more pulmonary veins into the systemic circulation. It can be isolated or associated with other congenital cardiac anomalies, most commonly atrial septal defect and patent ductus arteriosus. The clinical presentation is variable and depends on the degree of shunting and associated cardiac anomalies. Many patients usually remain asymptomatic until late in life. In this article, we presented a complex case of obstructive partial anomalous pulmonary venous drainage with dual drainage of bilateral accessory pulmonary veins with intact interatrial septum in conjunction with a patent ductus arteriosus and a ventricular septal defect. This pattern is incredibly rare and to the best of our knowledge has not been previously reported. Computed tomography played a pivotal role in precisely elucidating the intricate anatomy in this case with a complex pattern of anomalous pulmonary venous drainage.
RESUMO
Variant arch anatomy may be seen associated with many congenital heart diseases. Its accurate preoperative identification is of paramount importance in optimal surgical planning of such cases. This case describes one such variant arch anatomy with two vessel right aortic arch, comprising of bicarotid trunk (giving rise to bilateral common carotid arteries) and right subclavian artery with isolation of the left subclavian artery, in a patient with tetralogy of Fallot. Right aortic arch with isolated left subclavian artery has already been described in association with tetralogy of Fallot. However, to the best of our knowledge, present arch pattern consisting of right aortic arch with bicarotid trunk and isolated left subclavian artery has not been reported in literature so far. Moreover, this case highlights the utility of multidetector computed tomography in accurate identification of variant arch anatomy in addition to delineation of cardiac and extracardiac details.
