PMC6346793_01
Transoesophageal echocardiogram (TOE): pulse wave Doppler recording of the flow at the entrance of the right inferior pulmonary vein. The normal flow pattern is two forward waves during systole and maximum velocities of 57+-13 cm/sec (mean+-SD). However, in this case, increased velocities (up to 1.8 m/sec) indicative of significant intraluminar stenosis were seen
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Most importantly, increased velocities were recorded through the right lower pulmonary vein (Fig. 1).
PMC6346793_02
CT angiography: complete obstruction of the RIPV. The image shows the normal anatomy of the three pulmonary veins but complete obstruction of the RIPV
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Further work-up with cardiac CT showed no evidence of coronary artery disease but clearly demonstrated total occlusion of the right inferior pulmonary vein (Figs. 2 and 3).
CT angiography: total occlusion of the RIPV. The image demonstrates the total occlusion of the RIPV. The other three pulmonary veins have a normal anatomy. LIPV, left inferior pulmonary vein; LSPV, left superior pulmonary vein; RIPV, right inferior pulmonary vein; RSPV, right superior pulmonary vein
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Further work-up with cardiac CT showed no evidence of coronary artery disease but clearly demonstrated total occlusion of the right inferior pulmonary vein (Figs. 2 and 3).