Prenatal diagnosis of a mixed type of total anomalous pulmonary venous return.

Total anomalous pulmonary venous return (TAPVR) is a congenital heart malformation that can be diagnosed in the fetus by indirect indicators on an echocardiogram, such as inability to demonstrate the pulmonary veins returning to the left atrium by color Doppler, the presence of a chamber or the pulmonary venous confluence behind the left atrium, presence of a dilated superior vena cava, discrepancy between the right and left heart chambers and great arteries, and the demonstration of the ascending or descending common pulmonary vein or vertical vein. Some cases of TAPVR can be missed in utero, especially in a mixed type of TAPVR or a TAPVR associated with complex cardiac malformation. We report a case of a mixed TAPVR with complex cardiac malformation which was diagnosed in the fetal period by direct visualization of anomalous pulmonary venous drainage and was confirmed by postnatal echocardiogram and cardiac magnetic resonance imaging.