CTICasesTotal Anomalous Pulmonary Venous Return
Imaging findings
Chest CT in a newborn infant demonstrates a large right atrium, a dilated right ventricle, and a small left ventricle, with a large atrial septal defect (ASD). The pulmonary veins coalesce into a common venous confluence that drains inferiorly via a vertical vein into the inferior vena cava (IVC) below the level of the diaphragm, representing total anomalous pulmonary venous return (TAPVR) of the infracardiac type.
Key takeaways
Total anomalous pulmonary venous return (TAPVR) is a cyanotic congenital heart defect in which all four pulmonary veins fail to connect to the left atrium, instead draining into the systemic venous circulation. Infracardiac TAPVR (Type III) involves drainage below the diaphragm, usually via a descending vertical vein into the portal vein or IVC, and is frequently obstructed, presenting as a neonatal emergency with severe pulmonary edema.
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