Anomalous Pulmonary Venous Pathway Traversing Pulmonary Parenchyma

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Presentation transcript:

Anomalous Pulmonary Venous Pathway Traversing Pulmonary Parenchyma Jou-Kou Wang, MD, Ing-Sh Chiu, MD, Shu-Wen How, MD, Mei-Hwan Wu, MD, Fen-Fen Wu, MD, Chi-Ren Hung, MD, Hung-Chi Lue, MD CHEST Volume 110, Issue 5, Pages 1363-1366 (November 1996) DOI: 10.1378/chest.110.5.1363 Copyright © 1996 The American College of Chest Physicians Terms and Conditions

FIGURE 1 A chest radiogram of case 2 taken at cardiac catheterization showing a scimitar-like vascular structure (arrowheads) within the right lung. The catheter was placed in the aorta. CHEST 1996 110, 1363-1366DOI: (10.1378/chest.110.5.1363) Copyright © 1996 The American College of Chest Physicians Terms and Conditions

FIGURE 2 pulmonary venogram (case 2) showing an intrapulmonary segment of a vertical vein (star) with obstruction (arrowheads) at the junction with the right superior vena cava (SVC). The catheter was advanced from the right SVC to the vertical vein. CHEST 1996 110, 1363-1366DOI: (10.1378/chest.110.5.1363) Copyright © 1996 The American College of Chest Physicians Terms and Conditions

FIGURE 3 A series of horizontal sections on MRI from case 3. Pulmonary venous confluence (PVC) located behind the atrium. The pulmonary venous confluence traversed the right pulmonary parenchyma to form a vertical vein (W). Then the vertical vein ascended and joined with right superior vena cava (SVC). Arrowheads in panel 4 indicate a narrowing segment at the junction of vertical vein and superior vena cava. CHEST 1996 110, 1363-1366DOI: (10.1378/chest.110.5.1363) Copyright © 1996 The American College of Chest Physicians Terms and Conditions

FIGURE 4 A heart-lung specimen (case 4, anterior view, with the heart anteriorly reflected; the right lung was dissected along the course of vertical vein) shows the pulmonary venous confluence (PVC) traversed right pulmonary parenchyma and ascended as a vertical vein (W [arrows]) that received drainage from the small pulmonary veins (arrowheads) during the course to the drainage site. It then went across the midline to join the left superior vena cava. The pulmonary venous confluence was hypoplastic. A modified Blalock-Taussig shunt(s) was performed using a 4-mm Gore-Tex® graft (William Gore, Inc; Flagstaff, Ariz). CHEST 1996 110, 1363-1366DOI: (10.1378/chest.110.5.1363) Copyright © 1996 The American College of Chest Physicians Terms and Conditions