TITLE:
Persistent Cyanosis Revealing Supracardiac Total Anomalous Pulmonary Venous Return in an Infant: A Case Report
AUTHORS:
Sanae Kheir, Aziza El Ouali, Sara Anane, Maria Rkain, Abdeladim Babakhouya
KEYWORDS:
Total Anomalous Pulmonary Venous Return, Congenital Heart Disease, Thoracic CT Angiography, Pulmonary Hypertension
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.16 No.5,
September
4,
2026
ABSTRACT: Total anomalous pulmonary venous return is a rare congenital cardiac malformation and the supracardiac form is the most common subtype. The clinical appearance depends on the presence or absence of venous obstruction, which is a major prognostic factor. We report the case of a 2-month-old infant with persistent cyanosis from birth. On clinical examination, the patient had generalized cyanosis with a peripheral oxygen saturation of 60% on room air. Pulmonary hypertension, dilatation of the right ventricular chambers, and an atrial septal defect with a right-to-left shunt were all shown by transthoracic echocardiography. Thoracic computed tomography angiography confirmed supracardiac total anomalous pulmonary venous return with drainage of the pulmonary venous confluence via a vertical vein into the left brachiocephalic vein associated with hypoplasia of the left cardiac chambers. After the patient was stabilized, surgical intervention was recommended. This case illustrates the diagnostic value of a multimodal imaging approach, where echocardiography and CT angiography work synergistically to define the precise anatomy of supracardiac TAPVR and guide surgical referral. The unfortunate evolution in the postoperative period highlights the still present issue of late presentation and hemodynamic deterioration. It reminds us that the success of a surgical procedure relies not only on technical expertise but also on timely diagnosis and intervention.