This is an automatically translated article.
Abnormal return of the pulmonary vein completely is considered as one of the congenital anomalies, accounting for the current average rate, about 1-2%. This type of abnormal pulmonary vein malformation needs to be detected early to have the most effective treatment for the patient.
1. What is complete pulmonary venous return abnormality?
Abnormal complete pulmonary venous return is a condition in which the pulmonary veins do not empty into the left atrium, but the entire pulmonary venous return connects to the heart in other abnormal locations, which can also connect in other areas. the lower and posterior parts of the heart. This is a birth defect, also known as a birth defect. Some common clinical forms of pulmonary venous abnormalities are:
Pulmonary venous return to the unknown vena cava or superior vena cava. Pulmonary vein descends to the systemic circulation. The confluence of the pulmonary veins drains into the coronary sinus. In particular, the abnormal forms of the pulmonary vein draining below the diaphragm often face severe obstruction, causing cyanosis of the skin and mucous membranes, pulmonary edema that does not respond to treatment with oxygen support measures. . Other abnormalities usually do not cause obstruction, but may present with heart failure and mild cyanosis in the first years of life.
The clinical symptoms of pulmonary venous return are varied, and can cause respiratory failure, pulmonary edema, and cyanosis in neonates with obstruction. On physical examination, the lateral sternal pulsation can be observed, and the systolic murmur cannot be heard clearly. In contrast, neonates without pulmonary venous obstruction may experience mild heart failure, or infants with pulmonary venous return with complete cardiorespiratory status and non-obstruction in the heart may have no symptoms. clinically evident.
2. Abnormal diagnosis of pulmonary venous return completely
In addition to the clinical examination, the paraclinical facilities also contribute greatly in supporting the accurate diagnosis of this pathology. The first laboratory tests that can be easily applied to patients are chest X-ray or echocardiography.
In some other cases, cardiac MRI or CT angiography can be performed when necessary. With chest X-ray, it is possible to observe a small heart, complete pulmonary edema if there is an obstruction of pulmonary venous return, and also can see an enlarged heart, thickened pulmonary veins. The patient should also have an electrocardiogram, showing the right axis, right atrial enlargement, and increased right ventricular load.
Siêu âm tim là phương pháp quan trọng để chẩn đoán bất thường tĩnh mạch phổi.
3. Complete pulmonary vein treatment
There are 2 main methods to treat pulmonary venous return completely, which are:
Medical treatment to support heart failure in the pre-operative period: For medical treatment, drugs such as: Diuretic, ACE inhibitor, Digoxin. Surgery: Indicated in cases of abnormal pulmonary venous return with complete obstruction, perform pulmonary venous confluence with the posterior wall of the left atrium. In some other cases, it may be possible to cut the roof of the coronary sinus in the case of pulmonary veins emptying into the coronary sinus.
4. Conclusion
Abnormal return of the pulmonary vein completely is a birth defect that needs to be detected early for appropriate treatment, especially in the case of infants with pulmonary embolism.
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References: mayoclinic.org, cdc.gov, medlineplus.gov
