Surgical Ligation for Partial Anomalous Pulmonary Venous Connection With Dual Drainage in an Elderly Patient

Partial anomalous pulmonary venous connection with dual drainage into both the superior vena cava (SVC) and left atrium (LA) is a rare congenital anomaly, with few reported cases.

A 78-year-old woman presented with exertional dyspnea. Cardiac computed tomography revealed that the right pulmonary vein drained into both the SVC and LA, resulting in a significant left-to-right shunt. We ligated the anomalous connection with a median sternotomy. This approach allowed avoidance of complex reconstructions and cardioplegic arrest.

Simple ligation may represent a less invasive surgical option that avoids cardiac arrest and shortens operative time. Moreover, it may prevent pulmonary venous obstruction and future heart failure caused by right heart volume overload.

In elderly patients with heart failure caused by partial anomalous pulmonary venous connection with dual drainage into both the SVC and LA, ligation of the left-to-right shunt may be less invasive and prevent late complications.