Total Anomalous Pulmonary Venous Connection - Autopsy Analysis of Seven Cases -

Abstract

We studied 7 autopsied cases of total anomalous pulmonary venous connecton (TAPVC). Three cases were supracardiac types, showing drainage to the innominate vein through the left vertical vein. Stenosis at the beginning of the vertical vein was associated in Case 1. The left upper pulmonary vein was connected distal to the stenosis, and the left upper pulmonary lobe were severely congested after surgical ligation of the upper portion of the vertical vein and anastomosis between the common pulmonary vein and left atrium. The vertical vein in Case 2 was interposed between the left pulmonary artery and the left main bronchus, and the long segment was stenotic. The collateral channel through the paraesophageal venous plexus was present. An obstructing or stenotic segment was not found along the whole pulmonary venous pathway in Case 3. One case was a cardiac type in which both right and left pulmonary veins united to produce a common pulmonary venous channel draining into a huge coronary sinus (Case 4). Case 5 and Case 6 were infracardiac types draining into a common hepatic vein through a small opening. The vertical segment of the common pulmonary veins was short, and individual pulmonary veins were slender and long. Case 7 was a mixed form of an anomalous drainage through the portal vein and the right superior caval vein, respectively. We could find the common features of the long and slender individual pulmonary veins in these cases and short transverse common pulmonary vein segments. Unifocal narrowing of 1 pulmonary vein was seen in 1 supracardiac type case, as well as in a mixed supracardiac type and infracardiac type case, which may be present as an unexplained pulmonary infiltration before and after surgery.