Total anomalous systemic venous drainage to the

left atriumA Sharp eye on left atrial isomerism is must

Introduction

Classification TASVD

Type I Type II Type IIIIVC to left-sided atrium IVC interruption IVC to accessory chamber (like

coronary sinus)

Type A: Hepatic veins to left-sided atrium

Type B: Hepatic veins to other site

Zhang ZW, Duan QJ, Gao Z, Ru W, Ying LY. Total anomalous systemic venous drainage to the left atrium. Ann Thorac Surg 2009;87:1599-601-13

Embryology

• Failure of regression of the right valve of systemic venous sinus (sinus venosus)• Systemic venous sinus being incorporated into the left atrium

Hemodynamic

• Left atrium forms the mixing chamber in the circuit• Similar to the case of a total anomalous pulmonary venous drainage• Oxygen saturation is equal in all the chambers

Diagnosis

• Echocardiography with agitated saline contrast follow up(caution :air embolism to brain and coronary)• CT scan helps confirm drainage of all veins

Treatment

• Surgery

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