Authors

• Amer Iglica — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-4677-8489
• Edin Begić — General Hospital “Prim.Dr. Abdulah Nakaš”, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0001-6842-262X
• Indira Melezović — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0009-0002-3942-062X
• Alden Begić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-5374-0892
• Alen Džubur — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0003-1198-540X
• Azra Durak-Nalbantić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-5175-8941
• Buena Aziri — School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0003-3622-253X
• Zijo Begić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0002-1863-5755
• Nadina Jakirlić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0003-3294-2142
• Fuad Zukić — Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina — ORCID: 0000-0003-0219-0867

Abstract

**Goal:** To demonstrate an accidental verification of sinus venosus atrial septal defect (SVASD) associated with a partial anomalous venous inflow of the pulmonary veins (upper right pulmonary veins drain into the superior vena cava). **Case presentation:** The patient presented for a systematic examination, where the competent physician heard a murmur with an intensity of 2 out of 6, according to Levine, over the precordium and was referred to transthoracic echocardiography (TTE), verifying enlargement of the right ventricle (basal 4.3 cm, TAPSE 21 mm), right atrium (5.3 cm), with moderate tricuspid regurgitation and right ventricular systolic pressure (RVSP) 55 mmHg, as well as a positive bubble test (right ventricular outflow tract (RVOT) 25 mm, RVOT velocity time integral (VTI) 42.1 cm, left ventricular outflow tract (LVOT) 20 mm, LVOT VTI-Qp/Qs ratio 2.53). A TEE was performed, which revealed sinus venosus atrial septal defect (SVASD) with a diameter of 6 mm, and then computed tomography (CT) angiography of the heart, with verification of partial anomalous pulmonary venous return (PAPVR) (**Figure 1**). FIGURE 1. Sinus venosus atrial septal defect with partial anomalous pulmonary venous return. **Conclusion:** In the case of enlargement of the right cavities, it is imperative to find the cause of the same, with the gold standard in the form of TEE (1, 2), SAVSD is a rare adult congenital heart disease, and the diagnosis itself must be accompanied by the findings of computed tomography of the heart, in order to analyze the existence of vascular anomalies.

Keywords

partial anomalous pulmonary venous return, atrial septal defect, transesophageal echocardiography

DOI

Literature

1. Riahi M, Forte MNV, Byrne N, Hermuzi A, Jones M, Baruteau AE, et al. Early experience of transcatheter correction of superior sinus venosus atrial septal defect with partial anomalous pulmonary venous drainage. EuroIntervention. 2018 October 20;14(8):868–76. https://doi.org/10.4244/EIJ-D-18-00304
2. Vodusek Z, Khaliqdina S, Borz-Baba C, Scandrett R, Vodusek Z, Khaliqdina S, et al. Sinus Venosus Atrial Septal Defect: A Challenging Diagnosis. ureus. 2019 Oct 17;11(10):e5936. https://doi.org/10.7759/cureus.5936