- Supracardiac Total Anomalous Pulmonary Venous Return
- Dilated SVC secondary to increased right sided return from anomalous venous drainage
- PFO versus secundum ASD with septum primum tissue which bows towards the right atrium
- Pulmonary venous confluence seen posterior to left atrium
- Supracardiac Total Anomalous Pulmonary Venous Return
- Dilated SVC secondary to increased right sided return from vertical vein
- PFO versus secundum ASD with right to left shunting
- Flow seen within confluence posterior to left atrium
- Supracardiac Total Anomalous Pulmonary Venous Return
- Dilated SVC secondary to increased right sided return from anomalous venous drainage
- Turbulent flow in SVC by color Doppler reflective of increased volume of flow from anomalous pulmonary veins
- Supracardiac Total Anomalous Pulmonary Venous Return
- Dilated SVC with increased right sided return via a vertical vein
- PFO with exclusively right to left shunting
- Flow seen traveling superiorly from confluence which likely represents the start of the vertical vein
Echocardiographic Assessment: Apical 4 Chamber
- Right atrial size (often dilated in setting of anomalous venous return)
- SVC (often dilated, flow turbulence by color Doppler in setting of anomalous pulmonary venous return)
- Atrial septal defect (size and direction which is often exclusively right to left and mean gradient across ASD)
- Pulmonary venous confluence (posterior to left atrium)
- Venous drainage into pulmonary venous confluence
- Assess individual veins if possible (by 2D, color and spectral Doppler)
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- Transducer on abdomen just below xyphoid process
- Notch at 6 o'clock
- Probe tilted towards patient's right shoulder