CTICasesTotal Anomalous Pulmonary Venous Return (TAPVR) with Anomalous Systemic Venous Drainage (IVC to Left Atrium)
Imaging findings
Chest CT demonstrates a unique variant of total anomalous pulmonary venous return combined with anomalous systemic venous drainage. The pulmonary veins coalesce and drain into the inferior vena cava. Uniquely, the inferior vena cava itself then drains anomalously into an anatomically correct left atrium instead of the right atrium. A large atrial septal defect and a ventricular septal defect are also present.
Key takeaways
In infracardiac total anomalous pulmonary venous return, the pulmonary veins typically drain into the portal vein or inferior vena cava, which then returns blood to the right atrium. When the inferior vena cava itself drains anomalously into the left atrium, it creates a unique mixing physiology and anatomical challenge, though it may functionally balance shunt-related symptoms because oxygenated venous return goes directly to the systemic circulation.
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