Failed Left Atrial Vent Insertion During Mitral Valve Surgery Due to Anomalous Unilateral Single Pulmonary Vein.

BACKGROUND

Anomalous unilateral single pulmonary vein (AUSPV) is extremely rare and usually managed conservatively, requiring caution when accompanied by other heart diseases.

CASE SUMMARY: A 73-year-old woman who presented with exertional dyspnea was diagnosed with severe mitral valve insufficiency. During surgery, there were challenges inserting a left atrial vent tube owing to an anomaly of the right pulmonary vein. A review of preoperative contrast-enhanced multidetector computed tomography (CT) revealed AUSPV. Her postoperative course was generally favorable, and she was transferred to another hospital on postoperative day 23.

DISCUSSION: We present a case of AUSPV with severe mitral regurgitation; however, we were unable to diagnose AUSPV preoperatively. Preoperative CT is essential to confirm the course of the pulmonary veins.

TAKE-HOME MESSAGES: AUSPV is an extremely rare anomaly encountered during adult cardiac surgery. Before vent tube insertion, preoperative CT evaluation of the pulmonary vein anatomy is essential.