Total anomalous pulmonary venous connection

• pulmonary veins do not drain to left atrium. they drain somewhere else

  • nonobstructive: supradiaphragmatic: drain into superior vena cava

  • obstructive: infradiaphragmatic: drain into portal vein; liver imposes some level of obstruction

• leads to right heart hypertrophy and dilatation

supradiagphragmatic gross specimen (nonobstructive)

• left pulmonary veins and right pulmonary veins form a common pulmonary vein emptying into the left innominate (brachiocephalic) vein

infradiaphragmatic gross specimen (obstructive)

• anomalous vertical vein anastamoses to portal vein

• this blood must go through the hepatic sinusoids before returning systemically, and this leads to obstruction

Category: Pathology Notes