Prenatal Diagnosis of Isolated Total Abnormal Pulmonary Venous Connection during Routine Ultrasound Scans: Case Studies and Literature Review

We report two cases of prenatal diagnosis of isolated Total Anomalous Pulmonary Venous connection. We sought to assess the sonographic features leading to the mentioned diagnosis in affected fetuses. We identified the anomalous pulmonary venous confluence behind the Left Atrium and connection via ascending Vertical Vein to the left Brachiocephalic Vein in supracardiac type and via descending Vertical Vein to the Left Portal Vein in the infracardiac type. Doppler imaging of anomalous pulmonary confluence has not shown any obstruction. Both diagnoses were missed during the routine 18-20 weeks' scan and made later, at 24 and respectively 27 weeks of gestation. In the first case the diagnosis was confirmed postnatally by contrast enhanced computed tomography and surgery. In the second case the prenatal findings were confirmed during autopsy.