Agitated Saline Echo (what we order at Johns Hopkins Hospital to screen for PAVMs). Other names for this test include: Bubble study, Agitated saline transthoracic contrast echocardiograpy/TTCE, Contrast Echo, Contrast Echocardiography Right Anterior Oblique Halfway in between sagittal and coronal Notch at 1-2 o'clock Best view for seeing the 5 leaflets of common AV valve (Complete AV Canal Defect) RVOT and pulmonary infundibular area TOF and PS Usually most aligned with pulmonary outflow to get highest gradient across RVOT and pulmonary valv 2) in the last 6 years (2008-2014) at the Wuhan Union Hospital. The total anomalous pulmonary venous connection (TAPVC) cases account for 60.7%, and partial anomalous pulmonary venous connection (PAPVC) cases account for 39.3% among the 84 cases that were identified. The 51 TAPVCs were classified by the Darling method—type I (41.1%), type II (52.9%), type III (1.9%), and type IV (3.9%. Except for patients with scimitar syndrome, most patients with PAPVR are relatively older at presentation and do not have cyanosis. The primary physiologic process is a large left-to-right shunt, similar to that in cases of atrial septal defect. Patients with PAPVR present with heart murmurs, fatigue, dyspnea, and arrhythmias
3. Discussion . Partial anomalous pulmonary venous return (PAPVR) is a rare congenital abnormality in which one or more (but not all) of the pulmonary veins drain to the right atrium, directly or most frequently through one of its tributary veins .The prevalence of PAPVR is about 0,4-0,7% and it is usually incidentally detected on cross-sectional imaging  A persistent left superior vena cava is an abnormality which is seen in the great artery view. It is a common normal variant (the incidence in the normal population is about 1 : 300). A left superior vena cava drains into the coronary sinus behind the left atrium, causing dilatation of the coronary sinus. Hence, its distal portion is easily. A semi-quantitative analysis of the shunt size was performed according to the contrast echo opacification of the left-sided chambers: Grade 0, no bubbles; 1, occasional filling with <20 bubbles; 2, moderate filling; 3, complete opacification. The first 100 patients were compared with 100 controls
In partial anomalous venous return (PAPVR), if only one vein is affected, there are usually no symptoms. If two veins from the same side are affected, symptoms of shortness of breath with exertion and low stamina may occur during childhood. The symptoms are usually mild and may not ever occur Partial anomalous pulmonary venous return (PAPVR) is a rare congenital heart disease that usually involves the right pulmonary vein (PV) and an atrial septal defect (ASD). Isolated PAPVR with an intact atrial septum is pressure study and the atrial septum was intact on echo-cardiography. Contrast-enhanced computed tomography (CT) revealed. Cardiovascular anomalies in pediatric patients with Turner syndrome include aortic abnormalities and PAPVR. The significant association between elongation of the transverse aortic arch and CoA, BAV, and aortic sinus dilatation may contribute to increased risk of aortic dissection. The presence of PA Echocardiogram (echo). A procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves. Cardiac catheterization can echocardiography miss asd? i had about 5 and after, 25 years a ct scan just picked up a papvr. i was wondering if, they could, have missed asd as well? as i know sometimes asd and papvr coincide. .
For patients with anomalous pulmonary venous return, echocardiography is the preferred examination. [ 7, 8, 9] The echocardiogram demonstrates an enlarged right ventricle and a small left atrium... Total anomalous pulmonary venous return (TAPVR) is a congenital heart defect. This means that your child is born with it. It happens as the baby's heart develops during the first 8 weeks of pregnancy. In this condition, the 4 blood vessels (pulmonary veins) that carry oxygen-rich (red) blood to the heart from the lungs aren't connected right
PAPVR is usually diagnosed by transthoracic echocar-diography (TTE) or transesophageal echocar-diography (TEE) and catheter based angiography [5,6]. However, echocardiography can provide insufficient information, mainly due to its limited acoustic window. Right heart catheterization with pulmonary angiography is an opera The present series describes a group of adults with left-to-right shunts including partial anomalous pulmonary venous return (PAPVR) and/or an atrial septal defect (ASD) evaluated with ECG-gated 128-slice multidetector computed tomography (MDCT). PAPVR is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium (PAPVR) Right veins (more common): RA SVC ( RUPV to the RA or base of the SVC-sinus venosus ASD) IVC Left veins: Innominate vein You are doing the echo on a baby and diagnosis her with an Unbalanced AVC. You are having a hard time imaging the aortic arch. Are you concerned, or do you think to yourself, the arch i In PAPVR, rather than an anomalous pulmonary vein draining into the left atrium, one anomalous pulmonary vein drains into a systemic vein, producing a left-to-right shunt. The prevalence of this condition ranges from 0.4% to 0.7% . Patients with PAPVR are often asymptomatic or show few symptoms; and in most cases, PAPVR is detected incidentally PAPVR is a congenital anomaly in which up to 3 pulmonary veins may drain into the right atrium or one of its tributaries, instead of the left atrium, creating an extra cardiac left-to-right shunt. 4 The overall incidence of PAPVR is approximately 0.5%.5, 6, 7 Classically, a partial anomalous pulmonary venous connection has been described as presenting in childhood, most frequently on the right.
Scimitar PAPVR case: The images of the gradient echo CINE MRI on the axial plane show a slightly smaller RPA. Figure 9.3: Scimitar PAPVR case: The MRA with gadolinium contrast injection reveals Scimitar PAPVR of the mid right pulmonary veins (arrow sign) drainage into the IVC Cardiology Abbreviations and Diagnosis . AO Clinic=Aortopathy Clinic, UCP Clinic=UCHAMP Clinic, IA Clinic=Inherited Arrhythmia Clinic . Abbreviation Diagnosis Provider/Specialt Case Discussion. Partial anomalous pulmonary venous return (PAPVR) has a prevalence of 0.5% in the general population 1.Anomalous pulmonary vein drains into the pulmonary circulation via the superior vena cava (SVC), azygos, innominate veins, inferior vena cava (IVC), coronary sinus or right atrium) creating a pulmonary-to-systemic shunt. 1,2 Patients may be asymptomatic if the shunt is small
PAPVR - Partial Anomalous Pulmonary Venous Return the echo-cardiogram showed the valves working fine. No sign of any blockages, either. At least that was good news. DigDog Lifer. Jun 3, 2011 11,770 1,156 126. Oct 25, 2018 #21 The reason why they didnt tell you is likely because 1. You would be better off not knowing, and 2 Partial anomalous pulmonary venous return (PAPVR) is a congenital heart defect, which means it's present at birth. It happens when one or more of a baby's veins are attached to the wrong part of the heart or another blood vessel. Although PAPVR is partial and not as critical as total anomalous pulmonary venous return (TAPVR), early. I have a severely dilated left atrium. What does the doctor mean when he says we'll watch it ? I am a 44-year-old black female who just found out a couple of days ago that my left atrium is severely dilated and my cardiologist told me today that we will just watch it
The incidence of PAPVR in our study (15.7%) was similar to that in an MRA study of adults with Turner syndrome (13%) . This incidence is significantly higher than that of PAPVR in the general population . Furthermore, our patients with PAPVR had functional hemodynamic abnormalities, including significantly increased right ventricular volume and. . Rarely, it can be mal-positioned in an anomalous pulmonary vein. We present an unusual case of a 56-year-old woman that was found to have partial anomalous pulmonary venous return on central venous line insertion. In this report, we describe a systematic approach to diagnosis and management of this unusual situation
The study identified PAPVR in 7 % (1/14) of the patients with inferior SVDs and 3.5 % (5/14) of the patients with secundum ASDs. Surgical diagnosis and preoperative TTE correlated for 143 (89 %) of the 161 patients. Using a strict anatomic and echocardiographic definition with a blinded observer, the majority of the defects (14/18, 78 %) were. A Partial anomalous pulmonary venous connection (or Partial anomalous pulmonary venous drainage or Partial anomalous pulmonary venous return) is a congenital defect where the left atrium is the point of return for the blood from some (but not all) of the pulmonary veins. It is less severe than total anomalous pulmonary venous connection which. PAPVD was frequently missed in patients presenting with suspected PH. L-R shunt was higher in patients with associated ASD. Although patients may have other potential causes of PH, some patients with.. (PAPVR). Associations between the cardiac MRI data and the following factors were assessed: age, karyotype, body surface area, blood pressure, and ventricular sizes and function. RESULTS. Sixteen patients (31.4%) had elongation of the transverse aortic arch, eight (15.7%) had CoA, 20 (39.2%) had BAV, and eight (15.7%) had PAPVR. Aortic.
Partial anomalous pulmonary venous return (PAPVR) is a heterogenous group of lesions where at least one, but not all, of the pulmonary veins drain into the right heart or systemic veins. Similar to total anomalous pulmonary venous return (TAPVR), PAPVR can be associated with a wide variety of intracardiac lesions, particularly when asso In 6 patients with partial anomalous pulmonary venous return (PAPVR), oblique axial cine phase-contrast imaging (velocity encoding, 200 cm/s; direction, through-plane; repetition time, 33 ms; echo time, 6.2 or 6.3 ms; flip angle, 20°; slice thickness, 7 mm; matrix, 256×128; field of view, 25 to 35 cm) was performed through the base of the heart taining echo data. Thus, 2-D echocardiographic visualization of SVC dilatation might be useful clinically when IVC dilata-tion is uncertain or when the IVC cannot be imaged because of obesity, recent epigastric incision, or bandages. 1 In a Doppler study by Byrd and Linden, the SVC flow ve-locity was measured from the right supraclavicular. Figure 9.1: Scimitar PAPVR case: The multi-slice images with whole heart and great vessels coverage of the gradient echo CINE MRI on axial plane are used as scout images. The images reveal scimitar syndrome (dextro-cardia) hypoplasia of the right pulmonary artery and the right lung and anomalous arterial supply of the right lower lobe from the. In my echo-cardiogram I did last year, it showed no ASD at all which I verified with my cardiologist. This makes PAPVR surgery much less complicated. I am hoping if it has to be done that they could use the less invasive method
Partial anomalous pulmonary venous return (PAPVR) Patent ductus arteriosus (PDA) Pulmonary atresia. Pulmonary stenosis (PS) Pulmonary valve regurgitation. Ross procedure. Sano shunt procedure. Sinus of Valsalva aneurysms. Subaortic membrane. Tetralogy of Fallot (TOF) Total anomalous pulmonary venous return (TAPVR) Transposition of the great. TY - CHAP. T1 - Partial anomalous pulmonary venous return (PAPVR) AU - Sykes, Anne Marie. PY - 2011/1/1. Y1 - 2011/1/1. N2 - Imaging description In partial anomalous pulmonary venous return (PAPVR) there is an abnormal connection between the draining veins of one or more lobes to a systemic venous structure that drains into the right side of the heart, resulting in a left-to-right shunt Introduction. A persistent left-sided superior vena cava (LSVC) is the most common variant of systemic venous drainage. It is present in ∼0.5% of the general population, and up to 10% of those with established congenital heart disease. 1 It results from a failure of obliteration of the left common cardinal vein, and typically drains the left subclavian and jugular veins into the right atrium. INTRODUCTION. Contrast echocardiography is a technique for improving echocardiographic endocardial border delineation and providing real time assessment of intracardiac blood flow. Agitated saline contrast provides contrast in the right heart and enables detection of right-to-left shunts
Vascular rings are malformations of the aortic arch in the main blood vessel that leads from the heart. Because of the malformation, the aortic arch and its branches partly or completely encircle the windpipe (trachea), the esophagus or both Total anomalous pulmonary venous connections seminar ppt. 1. TOTAL ANOMALOUS PULMONARY VENOUS CONNECTIONS 2. Defination TAPVC is the anomaly in which the pulmonary veins have no connection with the left atrium.Rather,the pulmonary veins connect directly to one of the systemic veins.A PFO or ASD is present essentially in those who survive after birth (obligatory shunt). When pulmonary veins. Right atrial enlargement is commonly present in individuals with hypertension. According to studies, RAE is present in about 50% of individuals with either treated or untreated hypertension
Total anomalous pulmonary venous return. Total anomalous pulmonary venous return (TAPVR) is a heart disease in which the 4 veins that take blood from the lungs to the heart do not attach normally to the left atrium (left upper chamber of the heart). Instead, they attach to another blood vessel or the wrong part of the heart The ligamentum arteriosum is a remnant of a blood vessel that exists normally in the fetus; it runs between the aorta and the pulmonary artery, and in doing so completes the ring and also might constrict the trachea and/or esophagus. The structure of the vascular ring and its relationship to the trachea and esophagus varies from child to child Left bundle branch block (LBBB) is an abnormal pattern seen on an electrocardiogram (ECG). More specifically, it indicates that the cardiac electrical impulse is not being distributed across the ventricles of the heart in the normal way. Left bundle branch block is important because it often indicates that some form of underlying cardiac.
Our site offers web-based registry review courses and practice exams for the ARDMS and CCI registries. Registry review products are available in Abdominal Ultrasound, Breast Ultrasound, OB GYN Ultrasound, Vascular Ultrasound, Adult Echocardiography and Sonographic Principles and Instrumentation. The detailed registry review courses are supplemented with numerous superior quality vascular. Pediatric Echo-Congenital Heart Defects. STUDY. PLAY. The first three branches of the aorta (in order) are: brachiocephatic artery, left common carotid artery, left subclavian artery. Veins always transport deoxygenated blood, and arteries always transport oxygenated blood. True or False
Demonstrated is a bicuspid aortic valve and history of coarctation repair within the first week of life by end to end anastomosis. MRI obtained for evaluation of distal arch. MRI findings: • PAPVR of left upper lobe to innominate vein: Qp:Qs of 1.4:1. • Mild residual narrowing of second transverse segment of the aortic arch Q26.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM Q26.2 became effective on October 1, 2020. This is the American ICD-10-CM version of Q26.2 - other international versions of ICD-10 Q26.2 may differ. Applicable To Peds Echo Lesson 3 - Atrial Septal Anomalies. STUDY. PLAY. ASD. Opening between the two atria. Results from failure of the atrial septum to close completely during atrial septation. Occur 1:1000 of population. Widely split & fixed S2. Primum & secundum types make up 67% of all ASDs Let it ECHO, Cebu City. 4,142 likes · 102 talking about this · 10 were here. Is a non-profit organization that help parents of kids with congenital heart.. This 23-years old lady was detected to have a sinus venous type ASD on echo. She was referred for a cardiac CT to look for anomalous pulmonary return of the right superior pulmonary vein. The CT shows classic anomalous drainage of the right superior pulmonary vein into the SVC (Fig. 1) as well as the high, sinus venous atrial septal defect (Fig.
A transthoracic echocardiogram (Echo) showed a large superior sinus venous septal defect with possible partial anomalous pulmonary venous return (PAPVR) of the right upper pulmonary vein to right atrium. Echo demonstrated moderately dilated right atrium and moderate-to-severely dilated right ventricle (RV). Coronary artery origins were normal Partial anomalous pulmonary venous return (PAPVR), also known as scimitar syndrome, is a rare entity that accounts for 0.5-1% of congenital heart disease . The main manifestation of this anomaly is an anomalous pulmonary venous return of part of the right lung to the inferior vena cava via an aberrant straight venous structure that simulates a.
Partial anomalous pulmonary venous return is a rare congenital cardiac anomaly that usually involves the right pulmonary vein and an atrial septal defect. Isolated partial anomalous pulmonary venous return with an intact atrial septum is even rarer, and this condition is usually treated surgically in younger patients. We describe isolated partial anomalous pulmonary venous return in a 65-year. PAPVR is an uncommon abnormality that may be incidentally detected at CT scans performed for other unrelated conditions, and it consists of one or more (but not all) anomalous pulmonary veins draining into a systemic vein [1, 2]. Our case presents a left-sided upper PAPVR through a curved vein that drains to left brachiocephalic vein Scimitar syndrome is a subtype of PAPVR in which part or all of the blood from the right lung is returned into the IVC. On chest X-ray, the outline of the anomalous drainage and associated congestion gives the appearance of a scimitar. 3. What is a sinus venosus defect? What is the sinus venosus
To the Boston Children's Hospital Cardiac ICU Handbook. Online supplement. To the Boston Children's Hospital Cardiac ICU Handboo The incidence of PAPVR is estimated at 0.4-0.7%. However, these results are based on autopsy studies, which may underestimate the actual prevalence as many patients with the disorder are asymptomatic
echo ﬁndings, perioperative antibiotics, and management con-cerns (Table 2); these details can be adapted based on speciﬁc institutional needs. As part of the handover, ventilator settings, rates of IV infusions, and, if present, temporary pacemaker variables (settings, sensing thresholds, and pacing thresholds Three-dimensional gadolinium-enhanced MRA using fast gradient-echo sequence provides further evaluation of any PAPVR. Coronal views are preferred to cover entire heart and major vessels. Alternatively, non-ECG-gated time-resolved MRA can be performed Iowa ACC- Echo Lecture series April 17th 2021 Complex CHD-Learning Objectives • Types of Cyanotic heart diseases and their pathophysiology - Not palliated/ Not repaired • Warden Operation: rerouting anomalous PAPVR to LA and SVC anastomosis to Rt. atrial appendage • Brock Operation: Pulmonary valvotomy Tetralogy of Fallot (TOF) 4/17.
consecutive patients with PAPVR to the SVC were identiﬁed, and no patient with PAPVR was excluded from the series. All 21 patients under-went the double-decker technique, and other procedures were not per-formed. Patients' median age at repair was 4.4 years (range, 0.9-55.9 years), and median body weight was 16.5 kg (range, 5.4-62 kg). O 2D echocardiogram performed in the parasternal short-axis view in a 4-month-old male infant with Kawasaki disease showing large coronary artery aneurysms involving the left main, left anterior descending (diameter 6.9 mm), and left circumflex (diameter 5.6 mm) coronary arteries Pediatric Echo is Different Anatomy and physiology over function Segmental approach for complex patients . Improved resolution • Heart is closer to chest wall • Higher frequency transducers PAPVR to IVC. PAPVR to SVC. Total Anomalous Pulmonary Venous Return (TAPVR) I: Supracardia
Partial anomalous pulmonary venous return (PAPVR) is a congenital heart defect. Reports of repair and treatment in pediatric cases have been published, but incidence of PAPVR in adults is not common. To our knowledge, there has not been a diagnosis of left-sided PAPVR after a heart transplant an in adult patient. A 62-year-old patient with ischemic cardiomyopathy and systolic heart failure. Tetralogy of Fallot is the most common congenital cyanotic heart disease. Advances in surgical repair recently facilitate survival of the affected patients into adulthood with good quality of life. Despite imaging plays crucial role in diagnosis of TOF patients, no single diagnostic modality suffices for complete evaluation of TOF. Thus, different diagnostic tools should be used alone or in. More information for parents of children with CAVC. Atrioventricular (AV) canal defect is a large hole in the center of the heart. It's located where the wall (septum) between the upper chambers (atria) joins the wall between the lower chambers (ventricles). This septal defect involves both upper and lower chambers Left-to-right shunts are characterized by pulmonary arterial overcirculation and lack of cyanosis. When cardiomegaly is present, the amount of cardiac enlargement is generally proportional to the increase in pulmonary vascularity. 1 Assessing left atrial enlargement is useful for distinguishing between left and right shunts. If the left atrium is enlarged, then the patient likely has a shunt.
ECHO + CMR Best Modality 50 y/o male murmur since childhood. CMR: confirmed small ASD but found partial anomalous venous return of the LUPV and lingula with RVEDVi 118 ml/m2 and Qp/Qs of 1.7 to 1 (mostly from PAPVR) Surgical repair of PAPVR only ASD left open (very small shunt) CMR better delineate disease in this settin Results. Triplicate measurements of blood flow from 4D-PC were highly consistent, particularly at the aortic and pulmonary valves (cv 2-3%). Flow measurements were reproducible by a second observer (ρ = 0.986-0.999).Direct measurements of shunt volume from anomalous veins and intracardiac shunts matched indirect estimates from the outflow valves (ρ = 0.966) Children with PAPVR are usually asymptomatic. 2. Physical findings are similar to those of ASD (Fig. 3-2). When associated with ASD, the S2 is split widely and fixed. When the atrial septum is intact, the S2 is normal. 3. The ECG shows RVH or RBBB or is normal. 4. CXR films show RAE, RVE, and increased PVMs. 5. Echo diagnosis of PAPVR is less.
DISCUSSION: PAPVR is a rare congenital heart disease that can present in varying states of progression depending on the size of the shunt. Diagnosing PAPVR can be a challenge, and many cases may be misdiagnosed or diagnosed incidentally, as in this case. Surgery is safe and typically effective at correcting the underlying shunt; however, surgery may not be necessary in patients with low shunt. ECHO n, % Elongation of the ascending aorta and aortic arch: 16 (45.7%) Not detected: Bicuspid aortic valve (BAV) 16 (41.0%) 14 (36.1%) Partial anomalous pulmonary venous return (PAPVR) 6 (17.1%) Not detected: Persistent left superior vena cava (PLSVC) 4 (11.4%) Not detecte A cardiac echocardiogram (echo), using sound waves (ultrasound) to produce images of the heart and blood vessels' structures on a screen. This reveals whether the heart is pumping properly. An electrocardiogram (EKG or ECG), a painless exam, which checks the heart's electrical action to reveal damage or irregular rhythms, suggesting. PAPVR occurs when some, but not all, of the four pulmonary veins carrying blood from the lungs don't connect with the left atrium. There are many variations of this congenital (present at birth) heart defect. The anomalous (abnormal) vein or veins may connect to various structures, such as the superior vena cava, inferior vena cave, right. Pulmonary anomalous venous return (PAPVR) is defined as a congenital anomaly in which at least one but not all of the pulmonary veins abnormally drain into a systemic vein or directly into the right atrium. Signs and symptoms related to this condition are due to the hemodynamic abnormalities secondary to left-to-right shunt and the possible presence of other associated cardiac anomalies (e.g.
Total anomalous pulmonary venous return is a congenital (meaning it's present from birth) heart disease that affects the pulmonary veins. Arteries carry blood away from the heart; veins carry it toward the heart. The pulmonary veins are very important: they carry the red blood that has picked up oxygen in the lungs back to the heart to be. Study Flashcards On Echo 2 Test 3/ Final Review at Cram.com. Quickly memorize the terms, phrases and much more. Cram.com makes it easy to get the grade you want
-Echo- check septum..., can be hard to see w tte, but c/s it if u see turbulent Q in SVC or a vol OD to RA or RV w/other explanation. c/s TEE if needed -if a high SV defect w PAPVR, then must do repair w a tunnel connecting anamalous vn return with the ASD, w an autologous pericardial patc PAPVR is an uncommon abnormality that may be incidentally detected at CT scans performed for other unrelated conditions, and it consists of one or more (but not all) anomalous pulmonary veins draining into a systemic vein [1,2]. Our case presents a left-sided upper PAPVR through a curved vein that drains to left brachiocephalic vein TOF, APV: 2D Echo- Subxiphoid Short-Axis View, Conal Septum, Dilated MPA Two-dimensional echocardiogram obtained in a 2.8 kg neonate with tetralogy of Fallot and dysplastic pulmonary valve syndrome. A subxiphoid short-axis view initially shows both ventricles and the interventricular septum Anemia and Fatigue. Symptoms: Fatigue, dizziness, feeling cold, crankiness. Anemia is the most common blood condition in the U.S. It affects more than 5.6% of Americans. For women in their. Overview. Pulmonary arterial hypertension (PAH) is a rare but serious type of high blood pressure. It mimics several other heart and lung conditions
PAPVR was first described by Winslow in 1739 (3). When an ASD is detected on an Echo, it is always necessary to look for an associated PAPVR. It is difficult to differentiate the symptoms, signs, electrocardiographic and radiologi-cal findings of isolated ostium secundum ASD findings. An Echo usually confirms the diagnosis. PAPVR is rare Pulmonary arterial hypertension (PAH) is a type of high blood pressure that affects the heart and lungs. Here, learn about the prognosis and life expectancy for PAH The heart enlarges because of damage to the heart muscle. Up to a point, an enlarged heart can still pump blood normally. As the condition progresses, though, the heart 's pumping ability declines. Double outlet right ventricle (DORV) is a heart disease that is present from birth (congenital).The aorta connects to the right ventricle (RV, the chamber of the heart that pumps oxygen-poor blood to the lungs), instead of to the left ventricle (LV, the chamber that normally pumps oxygen-rich blood to the body) Bottom Line: PAPVR is defined as a left-to-right shunt where one or more, but not all, pulmonary veins drain into a systemic vein or the right atrium.PAPVR involving the right upper pulmonary vein can be associated with a sinus venosus ASD.The presence, course, number of anomalous veins and associated cardiovascular defects can be reliably observed by 128-slice MDCT angiography