Case Report: Analysis of the missed diagnosis of atrial septal defect with partial pulmonary vein dual drainage
Year: 2026
Type: article
Study design: Case Report
Abstract: Objective: This study aimed to investigate the reasons for the misdiagnosis of a case of atrial septal defect (ASD) complicated by partial anomalous pulmonary venous connection (PAPVC) to improve clinical diagnosis accuracy in similar cases. Methods: The clinical data, imaging findings, and surgical records of a patient with ASD complicated by PAPVC in our department were retrospectively analyzed, and the reasons for the missed diagnosis were comprehensively analyzed in combination with the literature. Results: The patient was diagnosed with PAPVC at another hospital; however, neither PAPVC nor ASD was identified on transthoracic echocardiography at our hospital. Cardiac CT and pulmonary angiography showed that the right upper pulmonary vein communicated with both the superior vena cava and the left atrium at the same time; however, the presence of an ASD was still not detected. An upper cavity ASD was found during thoracoscopic orthodontic surgery for downward PAPVC. Conclusion: The diagnosis of superior vena cava ASD associated with anomalous pulmonary vein drainage is prone to missed diagnosis, and when the pulmonary vein drains into both the superior vena cava and the left atrium at the same time, it increases the difficulty of detecting PAPAC by echocardiography. During transesophageal echocardiography examination, the integrity of the atrial septum should be repeatedly assessed in multiple sections, and continuous tracking of the pulmonary veins can help reduce the risk of missed diagnoses in similar cases. In addition, surgeons should fully communicate with echocardiographers and imaging specialists before surgery to formulate an individualized surgical plan.
Authors: Chi-heng Zhou, Yuan-yuan Zhang, Qun-shan Shen
Institution: Wuhan Asia Heart Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7140547137