A case of mixed drainage total anomalous pulmonary venous return in an adult patient

Total anomalous pulmonary venous return is observed in 1.5 to 3% of congenital heart diseases. Urgent surgical intervention is required following the diagnosis, since severe heart failure is accompanied by cyanosis from the first days of life in most of the patients. This rare congenital heart disease is often managed in adulthood with surgery. Patients who survive until adulthood without a surgical intervention have a large atrial septal defect. A 36-year-old female patient was admitted with complaints of fatigability, shortness of breath, and cyanosis of the lips. Total anomalous pulmonary venous return, secundum-type atrial septal defect, ventricular septal defect, and pulmonary hypertension were diagnosed by transthoracic echocardiography and catheter angiography. After medical treatment, surgery was planned for the patient who responded to the pulmonary vasoreactivity test with iloprost.