Partial Anomalous Pulmonary Venous Return Presenting in Adults: A Case Series With Review of Literature.

Partial anomalous pulmonary venous return (PAPVR) is a congenital anomaly in which some of the pulmonary veins drain erroneously into the superior vena cava (SVC) or directly into the right atrium (RA). We present four cases of PAPVR presenting in adults. We discussed various presentations, diagnostic approaches and challenges in the management of these patients. Our first case had anomalous drainage from the right upper lobe of lung to SVC and was managed medically with riociguat and ambrisentan. The second patient had an unsuccessful attempt at repair of the anomalous vein. Our other two patients had right upper lobe veins draining into SVC. One of them had a successful surgical repair whereas the other patient declined surgery and is being monitored. In PAPVR patients, the decision for surgical repair depends on symptoms, shunt fraction, recurrent pulmonary infections, and concurrent indication for cardiac surgery.