CTICasesMixed Total Anomalous Pulmonary Venous Return
Imaging findings
Contrast-enhanced chest CT in a three-day-old infant shows a mixed type of total anomalous pulmonary venous return. Three pulmonary veins (the left superior, left inferior, and right inferior) drain into a common vertical channel that courses inferiorly to join the hepatic portion of the inferior vena cava. Meanwhile, the right superior pulmonary vein drains separately into the superior vena cava. A patent ductus arteriosus is also noted with right-to-left shunting.
Key takeaways
Total anomalous pulmonary venous return (TAPVR) is a congenital cardiac defect where all pulmonary veins drain into the systemic venous circulation. Mixed TAPVR involves pulmonary veins draining to multiple different systemic sites (e.g., both supracardiac and infracardiac). It is a surgical emergency in newborns, often presenting with cyanosis and respiratory distress.
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