Evaluation of total anomalous pulmonary venous drainage with cross-sectional colour-flow Doppler echocardiography

Three patients with total anomalous pulmonary venous drainage (TAPVD) were studied by real-time cross-sectional colour-flow Doppler echocardiography. Serial suprasternal, parasternal and subcostal scans were obtained. In all cases surgical or angiocardiographic confirmation was available. Two patients had supracardiac drainage (to the left vertical vein or to the right superior vena cava) and one patient had infracardiac drainage. An abnormal forward flow in the left innominate vein and vertical vein was visualized in those patients with supracardiac TAPVD. Abnormal venous flow was also imaged in one patient with mixed drainage. In the patient with infradiaphragmatic TAPVD characteristic flow signals were identified in the inferior vena cava (retrograde flow) and in the descending aorta and anomalous pulmonary venous channel (forward flow). In all patients the patterns of pulmonary venous flow allowed us to distinguish TAPVD from contiguous structures and to validate two-dimensional cross-sectional imaging.