Noninvasive diagnosis and surgical management in total anomalous pulmonary venous return draining into the coronary sinus: report of 2 cases.

Total anomalous pulmonary venous return results from nondevelopment of the common pulmonary vein, with consequent enlargement of embryonic collaterals between the lungs and the systemic veins. In this report, two patients with this anomaly draining into the coronary sinus who presented in infancy are described. One of the patients was referred because of growth and development failure and chronic constipation, while the other had tachypnea as the presenting problem. Both were diagnosed during the echocardiographic examination. Typical echocardiographic findings were a small left atrium, a sausage-shaped dilated coronary sinus receiving the pulmonary veins in the subcostal short axis, and flying seagull configuration in the subcostal long axis views. Both had a large interatrial communication. The patients underwent corrective surgery. The aim of the presentation is to emphasize the role of segmental echocardiography in the differential diagnosis.