CTICasesPartial Anomalous Pulmonary Venous Return (PAPVR) and Cor Triatriatum Sinister
Imaging findings
Chest CT shows an anomalous vein draining all left pulmonary veins and an accessory right middle lobe pulmonary vein into the brachiocephalic vein, representing the extra-cardiac portion of partial anomalous pulmonary venous return. Additionally, the right superior pulmonary vein drains anomalously into the superior vena cava. A large inferior sinus venosus atrial septal defect is noted with an otherwise intact septum primum and secundum. There is a fibromuscular membrane within the left atrium, characteristic of cor triatriatum sinister, and the right heart chambers are significantly enlarged and hypertrophied.
Key takeaways
Partial anomalous pulmonary venous return can be associated with atrial septal defects, specifically sinus venosus defects. Cor triatriatum sinister is a rare congenital anomaly where a membrane partitions the left atrium into two chambers, which can alter normal pulmonary venous flow and exacerbate right heart strain and pulmonary hypertension.
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