CTICasesSinus Venosus Atrial Septal Defect with Partial Anomalous Pulmonary Venous Return
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Imaging findings
Contrast-enhanced chest CT shows right ventricular enlargement, right atrial dilatation, right ventricular free-wall thickening, and flattening of the interventricular septum, indicating right heart strain and pulmonary hypertension. A gated cardiac CT demonstrates a sinus venosus atrial septal defect variant, where an anomalous right upper lobe pulmonary vein drains into the superior vena cava (SVC), and a vascular channel creates a direct communication between the SVC and the left atrium.
Key takeaways
Sinus venosus atrial septal defects (ASDs) are frequently associated with partial anomalous pulmonary venous return (PAPVR), which leads to chronic left-to-right shunting, right-sided chamber overload, and eventually pulmonary arterial hypertension. This case presents an unusual variant where the communication manifests as a distinct vascular channel rather than a direct septal wall defect, illustrating the utility of ECG-gated cardiac CT in delineating complex venous anatomy for surgical planning.
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