Case report
A rare variant of intracardiac total anomalous pulmonary venous connection
Uma variante rara da conexão venosa pulmonar anómala total intracardíaca
Arun Gopalakrishnana,
, Venkateshwaran Subramaniana, Bijulal Sasidharana, Deepa Sasikumara, Kavassery Mahadevan Krishnamoorthya, Baiju S. Dharanb, Ajitkumar Valaparambila
Corresponding author
a Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Cardiology, Thiruvananthapuram, India
b Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Cardiovascular and Thoracic Surgery, Division of Congenital Heart Surgery, Thiruvananthapuram, India
Read
5763
Timeswas read the article
1721
Total PDF
4042
Total HTML
Share statistics
array:24 [ "pii" => "S2174204917303306" "issn" => "21742049" "doi" => "10.1016/j.repce.2017.11.009" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1100" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2017;36:869.e1-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1415 "formatos" => array:3 [ "EPUB" => 144 "HTML" => 1055 "PDF" => 216 ] ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S0870255117307825" "issn" => "08702551" "doi" => "10.1016/j.repc.2017.03.009" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1100" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2017;36:869.e1-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2295 "formatos" => array:3 [ "EPUB" => 167 "HTML" => 1776 "PDF" => 352 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "A rare variant of intracardiac total anomalous pulmonary venous connection" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "869.e1" "paginaFinal" => "869.e4" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Uma variante rara da conexão venosa pulmonar anómala total intracardíaca" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1649 "Ancho" => 2333 "Tamanyo" => 393823 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Subcostal transthoracic echocardiographic views showing the confluence of the pulmonary veins opening into the right atrium and an atrial septal defect with right-to-left shunt. ASD: atrial septal defect; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Arun Gopalakrishnan, Venkateshwaran Subramanian, Bijulal Sasidharan, Deepa Sasikumar, Kavassery Mahadevan Krishnamoorthy, Baiju S. Dharan, Ajitkumar Valaparambil" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Arun" "apellidos" => "Gopalakrishnan" ] 1 => array:2 [ "nombre" => "Venkateshwaran" "apellidos" => "Subramanian" ] 2 => array:2 [ "nombre" => "Bijulal" "apellidos" => "Sasidharan" ] 3 => array:2 [ "nombre" => "Deepa" "apellidos" => "Sasikumar" ] 4 => array:2 [ "nombre" => "Kavassery Mahadevan" "apellidos" => "Krishnamoorthy" ] 5 => array:2 [ "nombre" => "Baiju S." "apellidos" => "Dharan" ] 6 => array:2 [ "nombre" => "Ajitkumar" "apellidos" => "Valaparambil" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204917303306" "doi" => "10.1016/j.repce.2017.11.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917303306?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117307825?idApp=UINPBA00004E" "url" => "/08702551/0000003600000011/v2_201801180628/S0870255117307825/v2_201801180628/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S217420491730329X" "issn" => "21742049" "doi" => "10.1016/j.repce.2017.11.008" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1101" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2017;36:871.e1-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1248 "formatos" => array:3 [ "EPUB" => 119 "HTML" => 860 "PDF" => 269 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Heart transplantation for Chagas cardiomyopathy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "871.e1" "paginaFinal" => "871.e4" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Transplante cardíaco na miocardiopatia de Chagas" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 703 "Ancho" => 1667 "Tamanyo" => 153714 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Trypanosoma cruzi</span> intracytoplasmic amastigotes (arrows). Heart muscle, hematoxylin-eosin stain, 1000×.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Rita Ramalho, David Prieto, Fátima Franco, Manuel J. Antunes" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Ramalho" ] 1 => array:2 [ "nombre" => "David" "apellidos" => "Prieto" ] 2 => array:2 [ "nombre" => "Fátima" "apellidos" => "Franco" ] 3 => array:2 [ "nombre" => "Manuel J." "apellidos" => "Antunes" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255117307837" "doi" => "10.1016/j.repc.2016.08.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117307837?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491730329X?idApp=UINPBA00004E" "url" => "/21742049/0000003600000011/v1_201712190639/S217420491730329X/v1_201712190639/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2174204917302817" "issn" => "21742049" "doi" => "10.1016/j.repce.2017.06.008" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1071" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Rev Port Cardiol. 2017;36:859-67" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1911 "formatos" => array:3 [ "EPUB" => 123 "HTML" => 1354 "PDF" => 434 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>" "titulo" => "Sleep-disordered breathing in heart failure: The state of the art after the SERVE-HF trial" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "859" "paginaFinal" => "867" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Distúrbios respiratórios do sono na insuficiência cardíaca: o estado da arte depois do estudo SERVE-HF" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1000 "Ancho" => 1519 "Tamanyo" => 132754 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Adaptive servo-ventilation keeps the airway open by means of positive end-expiratory pressure and provides inspiratory pressure support during spontaneous breathing. When apnea occurs, it increases support pressure to provide minimum ventilatory reserve. As soon as spontaneous breathing returns, support is reduced. PEEP: positive end-expiratory pressure.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "João Carmo, Inês Araújo, Filipa Marques, Cândida Fonseca" "autores" => array:4 [ 0 => array:2 [ "nombre" => "João" "apellidos" => "Carmo" ] 1 => array:2 [ "nombre" => "Inês" "apellidos" => "Araújo" ] 2 => array:2 [ "nombre" => "Filipa" "apellidos" => "Marques" ] 3 => array:2 [ "nombre" => "Cândida" "apellidos" => "Fonseca" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0870255116302955" "doi" => "10.1016/j.repc.2017.06.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302955?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302817?idApp=UINPBA00004E" "url" => "/21742049/0000003600000011/v1_201712190639/S2174204917302817/v1_201712190639/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "A rare variant of intracardiac total anomalous pulmonary venous connection" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "869.e1" "paginaFinal" => "869.e4" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Arun Gopalakrishnan, Venkateshwaran Subramanian, Bijulal Sasidharan, Deepa Sasikumar, Kavassery Mahadevan Krishnamoorthy, Baiju S. Dharan, Ajitkumar Valaparambil" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Arun" "apellidos" => "Gopalakrishnan" "email" => array:1 [ 0 => "arungopalakrishnan99@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Venkateshwaran" "apellidos" => "Subramanian" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Bijulal" "apellidos" => "Sasidharan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Deepa" "apellidos" => "Sasikumar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Kavassery Mahadevan" "apellidos" => "Krishnamoorthy" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Baiju S." "apellidos" => "Dharan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Ajitkumar" "apellidos" => "Valaparambil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Cardiology, Thiruvananthapuram, India" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sree Chitra Tirunal Institute for Medical Sciences and Technology, Department of Cardiovascular and Thoracic Surgery, Division of Congenital Heart Surgery, Thiruvananthapuram, India" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Uma variante rara da conexão venosa pulmonar anómala total intracardíaca" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1547 "Ancho" => 2333 "Tamanyo" => 394871 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Subcostal transthoracic echocardiographic views showing drainage of the right and left pulmonary veins into the confluent chamber with a broad-mouthed opening into the right atrium. ASD: atrial septal defect; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">Total anomalous pulmonary venous connection (TAPVC) with direct connection of the pulmonary veins to the morphologically right atrium is exceedingly rare other than in the setting of isomerism of the right atrial appendages.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> We present an interesting case of TAPVC that connected to the right atrium via a broad-mouthed common chamber.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 42-day-old male baby born at term, weighing 3.5 kg, presented with history of feeding difficulty and oxygen saturation of 94% on room air. On evaluation he was diagnosed to have TAPVC to the right atrium with a mildly restrictive atrial septal defect (ASD) and severe pulmonary hypertension. There was no dysmorphism and no family history of congenital heart disease.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Echocardiography confirmed situs solitus and levocardia. All four pulmonary veins were imaged forming a confluence which opened directly into the right atrium with a mean gradient of 8 mmHg (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1–3</a>). There was no vertical vein and the coronary sinus was normal. Individual pulmonary veins were adequately sized. The ASD was of ostium secundum type, measuring 4.7 mm, with mildly restrictive peak and mean gradients of 5 and 1 mmHg, respectively. Surgical exploration revealed all pulmonary veins draining to the right atrium with a shelf over the opening of the left pulmonary veins. The patient underwent primary sutureless TAPVC repair and closure of the ASD with a tanned pericardial patch, and is doing well.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Supracardiac TAPVC draining into the innominate vein or other channels that connect into the systemic venous atrium is the most common type.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Classical cardiac-type TAPVCs drain into the coronary sinus. TAPVC with direct connection of the pulmonary veins to the morphological right atrium is exceedingly rare except in the setting of isomeric right atrial appendages.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> In our patient, the muscle-deficient confluence formed by the pulmonary veins draining to the right atrial roof was totally unexpected in the setting of normal atrial situs and normal coronary sinus anatomy. The gradient at the pulmonary venous confluence to the right atrium was flow-related, although the ASD was restrictive. The nomenclature of this defect is itself a point of debate – though anatomically intracardiac, embryologically it drains into the supracardinal venous system, mimicking a supracardiac TAPVC. Computed tomography is useful to delineate the size of individual pulmonary veins and the dimensions of the common chamber and its drainage in TAPVC.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Magnetic resonance imaging is rarely considered in sick neonates, despite its excellent accuracy, owing to the long duration of the study. However the same information can be obtained fairly reliably in most neonates with TAPVC from careful transthoracic echocardiography. In the case presented, the surgeon was confident of the size of the common chamber and the individual pulmonary veins from the echocardiographic images.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In primary sutureless surgical repair, as performed in our case, the proximity of the common chamber to both atria facilitates excellent results with primary surgical repair. While the initial surgical steps are similar, the required pericardial patch to close the original connection to the right atrium is considerably smaller than with other types of TAPVC. It is to be noted that pulmonary venous drainage from the right lung tracks right beneath this patch.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="par0030" class="elsevierStylePara elsevierViewall">Cardiac TAPVC draining to the right atrium is a rare variant with good surgical results. Anomalous connections to the right atrium can be diagnosed if there is no ascending or descending vein, the coronary sinus is of normal size and the pulmonary veins can be followed to their site of entry to the right atrium. Though it connects directly to the right atrium, embryologically it should be considered a supracardiac TAPVC. Systematic preoperative workup of TAPVC by a detailed echocardiographic assessment including the size of all individual pulmonary veins, the common chamber and ASD, screening for potential flow obstruction, can obviate the need for additional imaging.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres957271" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec928594" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres957270" "titulo" => "Resumo" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec928593" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Conclusions" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-05-21" "fechaAceptado" => "2017-03-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec928594" "palabras" => array:3 [ 0 => "Total anomalous pulmonary venous connection" 1 => "Cardiac total anomalous pulmonary venous connection" 2 => "Supracardiac total anomalous pulmonary venous connection" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec928593" "palabras" => array:3 [ 0 => "Conexão anómala total das veias pulmonares" 1 => "Conexão anómala total de veias pulmonares cardíaca" 2 => "Conexão anómala total de veias pulmonares supracardíaca" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Total anomalous pulmonary venous connection (TAPVC) with direct connection of the pulmonary veins to the morphologically right atrium is exceedingly rare other than in the setting of isomerism of the right atrial appendages. We present an interesting case of TAPVC in a patient with situs solitus that connected to the right atrium via a broad-mouthed common chamber.</p></span>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">As variantes de retorno venoso pulmonar anómalo total (RVPAT) que resultam de conexão e de drenagem direta das veias pulmonares à aurícula morfologicamente direita são extremamente raras, exceto no caso de presença de isomerismo direito. Apresentamos um caso de RVPAT, com drenagem à aurícula direita através de um coletor comum, num doente com <span class="elsevierStyleItalic">situs solitus</span>.</p></span>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1649 "Ancho" => 2333 "Tamanyo" => 393823 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Subcostal transthoracic echocardiographic views showing the confluence of the pulmonary veins opening into the right atrium and an atrial septal defect with right-to-left shunt. ASD: atrial septal defect; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1547 "Ancho" => 2333 "Tamanyo" => 394871 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Subcostal transthoracic echocardiographic views showing drainage of the right and left pulmonary veins into the confluent chamber with a broad-mouthed opening into the right atrium. ASD: atrial septal defect; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1571 "Ancho" => 2333 "Tamanyo" => 337237 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">High parasternal short-axis echocardiographic views showing the individual pulmonary veins connecting to the confluent chamber. LLPV: left lower pulmonary vein; LUPV: left upper pulmonary vein; RLPV: right lower pulmonary vein; RUPV: right upper pulmonary vein.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of the pulmonary vein and the systemic venous sinus: an interactive 3D overview" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. van den Berg" 1 => "A.F.M. Moorman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0022055" "Revista" => array:5 [ "tituloSerie" => "PLoS ONE" "fecha" => "2011" "volumen" => "6" "paginaInicial" => "e22055" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21779373" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Total anomalous pulmonary venous return" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P. Epifânio" 1 => "M. Emanuel Amaral" 2 => "Â. Moreira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Port Cardiol Engl Ed" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "243" "paginaFinal" => "244" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rare case of total anomalous pulmonary venous connection to the right atrium confounding with cor triatrium" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M. Fukazawa" 1 => "H. Orita" 2 => "S. Hirooka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Kyobu Geka" "fecha" => "1994" "volumen" => "47" "paginaInicial" => "295" "paginaFinal" => "298" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8152176" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR imaging and CT evaluation of congenital pulmonary vein abnormalities in neonates and infants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H.V. Vyas" 1 => "S.B. Greenberg" 2 => "R. Krishnamurthy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.321105764" "Revista" => array:6 [ "tituloSerie" => "RadioGraphics" "fecha" => "2011" "volumen" => "32" "paginaInicial" => "87" "paginaFinal" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22236895" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Total anomalous pulmonary venous connection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "N.T. Kouchoukos" 1 => "E.H. Blackstone" 2 => "F.L. Hanley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:6 [ "edicion" => "4th ed." "titulo" => "Kirklin/Barratt-Boyes Cardiac Surgery" "fecha" => "2013" "paginaInicial" => "1196" "paginaFinal" => "1198" "editorial" => "Elsevier/Saunders" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003600000011/v1_201712190639/S2174204917303306/v1_201712190639/en/main.assets" "Apartado" => array:4 [ "identificador" => "9919" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000011/v1_201712190639/S2174204917303306/v1_201712190639/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917303306?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 1 | 10 | 11 |
| 2024 October | 43 | 34 | 77 |
| 2024 September | 64 | 29 | 93 |
| 2024 August | 72 | 33 | 105 |
| 2024 July | 68 | 40 | 108 |
| 2024 June | 52 | 32 | 84 |
| 2024 May | 67 | 24 | 91 |
| 2024 April | 50 | 30 | 80 |
| 2024 March | 62 | 36 | 98 |
| 2024 February | 58 | 30 | 88 |
| 2024 January | 64 | 18 | 82 |
| 2023 December | 50 | 31 | 81 |
| 2023 November | 48 | 40 | 88 |
| 2023 October | 54 | 20 | 74 |
| 2023 September | 46 | 24 | 70 |
| 2023 August | 40 | 24 | 64 |
| 2023 July | 43 | 18 | 61 |
| 2023 June | 53 | 16 | 69 |
| 2023 May | 70 | 27 | 97 |
| 2023 April | 34 | 4 | 38 |
| 2023 March | 65 | 24 | 89 |
| 2023 February | 47 | 17 | 64 |
| 2023 January | 38 | 25 | 63 |
| 2022 December | 45 | 26 | 71 |
| 2022 November | 41 | 27 | 68 |
| 2022 October | 45 | 25 | 70 |
| 2022 September | 38 | 41 | 79 |
| 2022 August | 45 | 38 | 83 |
| 2022 July | 37 | 41 | 78 |
| 2022 June | 37 | 35 | 72 |
| 2022 May | 29 | 25 | 54 |
| 2022 April | 44 | 42 | 86 |
| 2022 March | 33 | 44 | 77 |
| 2022 February | 38 | 44 | 82 |
| 2022 January | 74 | 23 | 97 |
| 2021 December | 29 | 38 | 67 |
| 2021 November | 53 | 32 | 85 |
| 2021 October | 56 | 52 | 108 |
| 2021 September | 48 | 26 | 74 |
| 2021 August | 65 | 57 | 122 |
| 2021 July | 40 | 30 | 70 |
| 2021 June | 52 | 27 | 79 |
| 2021 May | 60 | 42 | 102 |
| 2021 April | 98 | 28 | 126 |
| 2021 March | 90 | 21 | 111 |
| 2021 February | 124 | 20 | 144 |
| 2021 January | 58 | 27 | 85 |
| 2020 December | 64 | 14 | 78 |
| 2020 November | 73 | 13 | 86 |
| 2020 October | 40 | 11 | 51 |
| 2020 September | 72 | 10 | 82 |
| 2020 August | 29 | 9 | 38 |
| 2020 July | 49 | 12 | 61 |
| 2020 June | 51 | 8 | 59 |
| 2020 May | 46 | 4 | 50 |
| 2020 April | 38 | 20 | 58 |
| 2020 March | 43 | 7 | 50 |
| 2020 February | 112 | 13 | 125 |
| 2020 January | 51 | 5 | 56 |
| 2019 December | 25 | 5 | 30 |
| 2019 November | 35 | 7 | 42 |
| 2019 October | 40 | 4 | 44 |
| 2019 September | 28 | 8 | 36 |
| 2019 August | 32 | 8 | 40 |
| 2019 July | 37 | 14 | 51 |
| 2019 June | 25 | 15 | 40 |
| 2019 May | 35 | 12 | 47 |
| 2019 April | 22 | 17 | 39 |
| 2019 March | 75 | 13 | 88 |
| 2019 February | 70 | 5 | 75 |
| 2019 January | 66 | 7 | 73 |
| 2018 December | 69 | 11 | 80 |
| 2018 November | 57 | 14 | 71 |
| 2018 October | 52 | 13 | 65 |
| 2018 September | 21 | 9 | 30 |
| 2018 August | 31 | 3 | 34 |
| 2018 July | 10 | 2 | 12 |
| 2018 June | 32 | 3 | 35 |
| 2018 May | 31 | 4 | 35 |
| 2018 April | 23 | 3 | 26 |
| 2018 March | 33 | 5 | 38 |
| 2018 February | 17 | 5 | 22 |
| 2018 January | 22 | 4 | 26 |
| 2017 December | 18 | 7 | 25 |
Show all
