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Total anomalous pulmonary venous drainage with major aorto-pulmonary collaterals – a diagnostic dilemma

^a Department of Cardiothoracic Surgery, Yorkshire Heart Centre, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK
^b Department of Pediatric Cardiology, Yorkshire Heart Centre, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK

*Corresponding author. Tel.: +44 7980631248; fax: +44 1133928092.

E-mail address: sanjaykr33{at}hotmail.com (S. Kumar).

A term female newborn presented with right atrial isomerism and infra-diaphragmatic total anomalous pulmonary venous drainage associated with complex cardiac anatomy. The repair was performed utilizing circulatory arrest in deep hypothermia. However, in the post-operative period the patient could not be weaned off mechanical ventilation and underwent cardiac catheterisation. This revealed major aortopulmonary collaterals, which were occluded with coils. We review the literature with specific focus on the occurrence of this unusual combination and its implication in the management during the postoperative period.

Key Words: Major aorto-pulmonary collaterals; Right atrial isomerism; Total anomalous pulmonary venous drainage; Infracardiac total anomalous pulmonary venous drainage; Heterotaxy syndrome