J Korean Soc Radiol.  2010 Oct;63(4):339-343.

Partial Anomalous Pulmonary Venous Return via a Levoatriocardinal Vein in Association with Rheumatic Mitral Stenosis: MR Demonstration and Successful Surgical Repair

• Hyun D
• Chae EJ
• Seo JB
• Kang JW
• Do KH
• Lee CW
• Lee HJ
• Hwang HJ
• Lim TH

Abstract

The preoperative evaluation of the hemodynamics associated with PAPVR and rheumatic mitral valve stenosis is necessary for successful surgical treatment, even though the incidence rate is rare. The purpose of this case report is to present the usefulness of CT and MRI for diagnosing rheumatic mitral stenosis and partial anomalous pulmonary venous connection to the left innominate vein accompanied by the presence of the levoatriocardinal vein and evaluating its flow dynamics.

MeSH Terms

Brachiocephalic Veins
Hemodynamics
Incidence
Magnetic Resonance Imaging
Mitral Valve Stenosis
Rheumatic Heart Disease
Scimitar Syndrome
Tomography, X-Ray Computed
Veins

Figure

• 

  Fig. 1 A. Axial CT image, at the level of the aortic arch, shows an abnormal vascular structure (arrow) located on the left side of the aortic arch. B. Axial CT image, at the level of the main pulmonary artery, shows an anomalous vein (arrow) located between the left pulmonary artery and the left bronchus. The left superior pulmonary vein (arrowhead) drains into this anomalous vein. C. Four-chamber cine MR image shows the giant left atrium and tight mitral stenosis with dark jet flow (dotted arrow). D. A MR coronal image shows the course of the levoatriocardinal vein (arrow), which is connected to the left innominate vein (open arrow). E-G. On sagittal MR images, the left superior pulmonary vein (arrowhead) drains into the levoatriocardinal vein (arrow). H. Velocity-encoded cine MR image provides information regarding the flow direction at the level of the superior vena cava (open arrow) and the levoatriocardinal vein (arrow).

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