Total anomalous pulmonary venous connection classification
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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]
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 ususally seen in infracardiac subtype though.
Classification
A common classification system for total anomalous venous connection (TAPVC) is as the following:[1][2]
- 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.[3]
- 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 drainages. Any combination of drainage may occur into superior vena cava, innominate veins, coronary sinus, RA, 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.
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.
- ↑ 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