A Case of Mixed Drainage Total Anomalous Pulmonary Venous Return in an Adult Patient

Abstract

Total anomalous pulmonary venous return is observed in 1.5 to 3% of congenital heart diseases. Urgent surgical intervention is required following the diagnosis, since severe heart failure is accompanied by cyanosis from the first days of life in most of the patients. This rare congenital heart disease is often managed in adulthood with surgery. Patients who survive until adulthood without a surgical intervention have a large atrial septal defect. A 36-year-old female patient was admitted with complaints of fatigability, shortness of breath, and cyanosis of the lips. Total anomalous pulmonary venous return, secundum-type atrial septal defect, ventricular septal defect, and pulmonary hypertension were diagnosed by transthoracic echocardiography and catheter angiography. After medical treatment, surgery was planned for the patient who responded to the pulmonary vasoreactivity test with iloprost.; Total anormal pulmoner venöz dönüş, doğuştan kalp hastaliklarinin %1.5-3'ünde görülür. Hastalarin çoğunda hayatin ilk günlerinden itibaren siyanoza ciddi kalp yetmezliği eslik ettiği için, taniyi takiben acil cerrahi girişim gerekmektedir. Bu nadir doğuştan kalp hastaliği, genellikle erişkin dönemde cerrahi ile tedavi edilir. Cerrahi girisim olmaksizin eriskin yaşa kadar ulasan hastalarda büyük bir atriyal septal defekt mevcuttur. Otuz alti yaşindaki kadin hasta çabuk yorulma, nefes darliği ve dudaklarda morarma yakinmalari ile başvurdu. Transtorasik ekokardiyografi ve kateter anjiyografide total anormal pulmoner venöz dönüs, sekundum tip atriyal septal defekt, ventriküler septal defekt ve pulmoner hipertansiyon saptandi. Iloprost ile yapilan pulmoner vazoreaktivite testine yanit veren hastaya tibbi tedavi sonrasinda cerrahi planlandi. © 2018 All right reserved by the Turkish Society of Cardiovascular Surgery.; © 2018 All right reserved by the Turkish Society of Cardiovascular Surgery.