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(Circulation. 2002;105:663.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Three-Dimensional Computed Tomography Showing Partial Anomalous Pulmonary Venous Connection Complicated by the Scimitar Syndrome

Teruo Inoue, MD; Michiko Ichihara, MD; Toshihiko Uchida, MD; Yoshihiko Sakai, MD; Terumi Hayashi, MD; Shigenori Morooka, MD

From the Department of Cardiology, Koshigaya Hospital Dokkyo University School of Medicine, Saitama, Japan.

Correspondence to Teruo Inoue, MD, Dept of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, 2-1-50 Minamikoshigaya, Koshigaya-City, Saitama 343-8555, Japan. E-mail inouet{at}dokkyomed.ac.jp

The patient is a 41-year-old woman who was referred to our hospital because of an abnormal chest radiograph. On admission, she was asymptomatic, but her cardiac silhouette was shifted to the right on chest radiograph. From contrast-enhanced chest computed tomography (CT), we suspected that the right upper pulmonary vein connected to the inferior vena cava. The CT also revealed hypoplasia of the right lung. The 3-dimensional imaging reconstructed from the CT clearly showed the right upper pulmonary vein connected to the inferior vena cava (Figure). During cardiac catheterization, oxymetry sampling showed a step up of the blood oxygen content at the inferior vena cava level just below the border of the right atrium, which indicated left-to-right shunting at this level. In addition, the upper pulmonary venous drainage into the inferior vena cava was also shown by pulmonary arteriography. This partial anomalous pulmonary venous connection associated with hypoplasia of the right lung and dextroposition of the heart is designated Scimitar Syndrome. Left-to-right shunt was slight and pulmonary hypertension was not present. Consequently, no surgical treatment was required.

View larger version (118K): [in this window] [in a new window]   Three-dimensional imaging in the right anterior oblique view, reconstructed from contrast-enhanced computed tomography. The image clearly shows that the right upper pulmonary vein was connected to the inferior vena cava (arrow).

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St.Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to the Circulation Editoral Office, St.Luke’s Episcopal Hospital/Texas Heart Institute, 6720 Bertner Ave, MCI-267, Houston, TX 77030.

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This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Inoue, T. Articles by Morooka, S. Search for Related Content PubMed PubMed Citation Articles by Inoue, T. Articles by Morooka, S. Related Collections Cardiovascular imaging agents/Techniques Pulmonary circulation and disease CT and MRI Pediatric and congenital heart disease, including cardiovascular surgery