Total anomalous pulmonary venous connection (TAPVC); cardiac type into right atrium (RA)

Total anomalous pulmonary venous connection (TAPVC) develops when the primordial pulmonary vein fails to unite with the plexus of veins surrounding the lung buds. In 1959, Darling and associates[1] proposed a classification, also based on the anatomy of the anomalous connection. Four types were identified: type 1, anomalous connection at the supracardiac level; type 2, anomalous connection at the cardiac level; type 3, anomalous connection at the infracardiac level; and type 4, anomalous connection at two or more of the above levels. Mixed TAPVC (type 4) is a rare condition, accounting for only 5% of diagnosed TAPVC.[2] It is associated with a poor prognosis unless surgically corrected by connecting the pulmonary venous sinus to the left atrium. We report a “3+1” variant of mixed TAPVC treated by rechannelizing all pulmonary veins to left atrium using a polytetrafleuroethylene (PTFE) patch.