An asymptomatic 12-year-old girl has an echocardiographic diagnosis of sinus venosus type atrial septal defect. Which additional anomaly must be actively searched for before planning closure?

• A Ventricular septal aneurysm
• B Patent ductus arteriosus
• C Persistent left superior vena cava
• D Partial anomalous pulmonary venous connection of the right upper pulmonary vein ✓

Explanation

Sinus venosus defects lie at the junction of the SVC and right atrium, near the entry of the right upper pulmonary vein, and are characteristically associated with partial anomalous pulmonary venous connection of that vein. Missing this leads to residual left-to-right shunt after device closure, and many such defects are unsuitable for devices precisely because of this anatomy. Persistent left SVC accompanies secundum defects and coronary sinus defects, not specifically sinus venosus.

Reference: Park's Pediatric Cardiology for Practitioners, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.