Total anomalous pulmonary venous connection classification: Difference between revisions
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{{Total anomalous pulmonary venous connection}} | {{Total anomalous pulmonary venous connection}} | ||
{{CMG}}; {{AE}} {{RT}} | {{CMG}}; {{AE}} {{RT}} {{Sahar}} | ||
==Overview== | |||
Total anomalous venous connection (TAPVC) is classified into four subtypes based on the location of [[pulmonary]] venous drainage. These subtypes include, supracardiac, cardiac, infracardiac, and mixed. Supracardiac (type I) is the most common form. [[Pulmonary]] venous obstruction is usually seen in infracardiac subtype though. Smith [[classification]] is another system that classified this disorder to two categories based on the presence of [[pulmonary]] obstruction and the location of anastomosis in relation to [[diaphragm]]. | |||
==Classification== | ==Classification== | ||
A common [[classification]] system for total anomalous venous connection (TAPVC) is as the following:<ref name="AlamHamidi2016">{{cite journal|last1=Alam|first1=Tariq|last2=Hamidi|first2=Hidayatullah|last3=Hoshang|first3=Mer Mahmood Shah|title=Computed tomography features of supracardiac total anomalous pulmonary venous connection in an infant|journal=Radiology Case Reports|volume=11|issue=3|year=2016|pages=134–137|issn=19300433|doi=10.1016/j.radcr.2016.04.005}}</ref><ref name="HinesHammon2001">{{cite journal|last1=Hines|first1=Michael H.|last2=Hammon|first2=John W.|title=Anatomy of Total Anomalous Pulmonary Venous Connection|journal=Operative Techniques in Thoracic and Cardiovascular Surgery|volume=6|issue=1|year=2001|pages=2–7|issn=15222942|doi=10.1053/otct.2001.22696}}</ref><ref name="pmid13386206">{{cite journal |vauthors=CRAIG JM, DARLING RC, ROTHNEY WB |title=Total pulmonary venous drainage into the right side of the heart; report of 17 autopsied cases not associated with other major cardiovascular anomalies |journal=Lab. Invest. |volume=6 |issue=1 |pages=44–64 |date=1957 |pmid=13386206 |doi= |url=}}</ref> | |||
* Supracardiac | * Supracardiac (type I) (approximately 50%): [[pulmonary veins]] form a transverse confluence just behind small [[left atrium]]. This confluence drains into the remnant of the left cardinal vein, then into the left [[innominate vein]], finally flows into the [[right atrium]]. | ||
* Cardiac | * [[Cardiac]] (type II) (approximately 25%): the common [[pulmonary vein]] drains into the [[coronary sinus]] or rarely the individual [[pulmonary veins]] connect directly into the [[right atrium]]. There is no connection between [[pulmonary veins]] and [[left atrium]] though.<ref name="SinghSingh2013">{{cite journal|last1=Singh|first1=N.|last2=Singh|first2=R.|last3=Aga|first3=P.|last4=Singh|first4=S. K.|title=Cardiac type of total anomalous pulmonary venous connection: diagnosis and demonstration by multidetector CT angiography|journal=Case Reports|volume=2013|issue=jan03 1|year=2013|pages=bcr2012007994–bcr2012007994|issn=1757-790X|doi=10.1136/bcr-2012-007994}}</ref> | ||
* Infracardiac | * Infracardiac (type III) (approximately 25%): the common [[pulmonary vein]] drains through the [[diaphragm]] into the [[portal vein]] or [[ductus venosus]] via a descending vertical vein | ||
* Mixed | * Mixed (type IV): the right and left [[pulmonary veins]] may have different drainage. Any combination of drainage is possible and it may occur into [[superior vena cava]], [[innominate veins]], [[coronary sinus]], [[right atrium]], [[azygous vein]], or infra diaphragmatic veins. | ||
===Image=== | |||
[[File:Total-anomalous-pulmonary-venous-return-illustration.png|thumb|center|500px|<ref> Case courtesy of Dr Vincent Tatco, Radiopaedia.org, rID: 51911</ref>]] | |||
Another system classifies TAPVC into two types depending on the obstruction of [[pulmonary veins]]. | |||
* [[Pulmonary vein]] obstruction occurs more commonly in type III. | |||
{| class="wikitable" | |||
|+ | |||
|- | |||
| style="background: #4479BA; width: 100px;" align="center"| {{fontcolor|#FFF|'''Type'''}} | |||
| style="background: #4479BA; width: 350px;" align="center"| {{fontcolor|#FFF|'''Site of drainage'''}} | |||
|- | |||
! style="padding: 5px 5px; background: #DCDCDC;" align="left" rowspan="5" |'''Supracardiac (type I)''' | |||
| | |||
* Left [[innominate vein]] | |||
|- | |||
| | |||
* Right [[superior vena cava]] | |||
|- | |||
| | |||
* Left [[superior vena cava]] | |||
|- | |||
| | |||
* [[Azygos vein]] | |||
|- | |||
| | |||
* Hemiazygos vein | |||
|- | |||
! style="padding: 5px 5px; background: #DCDCDC;" align="left" rowspan="2" |'''Cardiac (type II)''' | |||
| | |||
* [[Coronary sinus]] | |||
|- | |||
| | |||
* [[Right atrium]] | |||
|- | |||
! style="padding: 5px 5px; background: #DCDCDC;" align="left" rowspan="4" |'''Infracardiac (type III)''' | |||
| | |||
* [[Inferior vena cava]] | |||
|- | |||
| | |||
* [[Portal venous system]] | |||
|- | |||
| | |||
* [[Splenic vein]] | |||
|- | |||
| | |||
* [[Hepatic veins]] | |||
|} | |||
* Smith classification is another system that classified this disorder to two categories based on the presence of [[pulmonary]] obstruction and the location of anastomosis in relation to [[diaphragm]]:<ref name="Smith1961">{{cite journal|last1=Smith|first1=Blanca|title=Total Anomalous Pulmonary Venous Return|journal=American Journal of Diseases of Children|volume=101|issue=1|year=1961|pages=41|issn=0002-922X|doi=10.1001/archpedi.1961.04020020043008}}</ref> | |||
** Supradiaphragmatic without [[pulmonary] venous obstruction | |||
** infradiaphragmatic with [[pulmonary]] venous obstruction | |||
==References=== | |||
{{Reflist|2}} | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Sahar Memar Montazerin, M.D.[3]
Overview
Total anomalous venous connection (TAPVC) is classified into four subtypes based on the location of pulmonary venous drainage. These subtypes include, supracardiac, cardiac, infracardiac, and mixed. Supracardiac (type I) is the most common form. Pulmonary venous obstruction is usually seen in infracardiac subtype though. Smith classification is another system that classified this disorder to two categories based on the presence of pulmonary obstruction and the location of anastomosis in relation to diaphragm.
Classification
A common classification system for total anomalous venous connection (TAPVC) is as the following:[1][2][3]
- Supracardiac (type I) (approximately 50%): pulmonary veins form a transverse confluence just behind small left atrium. This confluence drains into the remnant of the left cardinal vein, then into the left innominate vein, finally flows into the right atrium.
- Cardiac (type II) (approximately 25%): the common pulmonary vein drains into the coronary sinus or rarely the individual pulmonary veins connect directly into the right atrium. There is no connection between pulmonary veins and left atrium though.[4]
- Infracardiac (type III) (approximately 25%): the common pulmonary vein drains through the diaphragm into the portal vein or ductus venosus via a descending vertical vein
- Mixed (type IV): the right and left pulmonary veins may have different drainage. Any combination of drainage is possible and it may occur into superior vena cava, innominate veins, coronary sinus, right atrium, azygous vein, or infra diaphragmatic veins.
Image
Another system classifies TAPVC into two types depending on the obstruction of pulmonary veins.
- Pulmonary vein obstruction occurs more commonly in type III.
| Type | Site of drainage |
| Supracardiac (type I) |
|
|---|---|
| |
| |
| |
| Cardiac (type II) | |
| Infracardiac (type III) | |
- Smith classification is another system that classified this disorder to two categories based on the presence of pulmonary obstruction and the location of anastomosis in relation to diaphragm:[6]
- Supradiaphragmatic without [[pulmonary] venous obstruction
- infradiaphragmatic with pulmonary venous obstruction
References=
- ↑ Alam, Tariq; Hamidi, Hidayatullah; Hoshang, Mer Mahmood Shah (2016). "Computed tomography features of supracardiac total anomalous pulmonary venous connection in an infant". Radiology Case Reports. 11 (3): 134–137. doi:10.1016/j.radcr.2016.04.005. ISSN 1930-0433.
- ↑ Hines, Michael H.; Hammon, John W. (2001). "Anatomy of Total Anomalous Pulmonary Venous Connection". Operative Techniques in Thoracic and Cardiovascular Surgery. 6 (1): 2–7. doi:10.1053/otct.2001.22696. ISSN 1522-2942.
- ↑ CRAIG JM, DARLING RC, ROTHNEY WB (1957). "Total pulmonary venous drainage into the right side of the heart; report of 17 autopsied cases not associated with other major cardiovascular anomalies". Lab. Invest. 6 (1): 44–64. PMID 13386206.
- ↑ Singh, N.; Singh, R.; Aga, P.; Singh, S. K. (2013). "Cardiac type of total anomalous pulmonary venous connection: diagnosis and demonstration by multidetector CT angiography". Case Reports. 2013 (jan03 1): bcr2012007994–bcr2012007994. doi:10.1136/bcr-2012-007994. ISSN 1757-790X.
- ↑ Case courtesy of Dr Vincent Tatco, Radiopaedia.org, rID: 51911
- ↑ Smith, Blanca (1961). "Total Anomalous Pulmonary Venous Return". American Journal of Diseases of Children. 101 (1): 41. doi:10.1001/archpedi.1961.04020020043008. ISSN 0002-922X.