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    Partial anomalous pulmonary venous return
    Diagnosis and treatment

    By Mayo Clinic Staff
    Jan. 10, 2025
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    Diagnosis

    To diagnose partial anomalous pulmonary venous return (PAPVR), a healthcare professional does a physical exam and listens to the heart and lungs. A whooshing sound, called a heart murmur, may be heard if there is a hole in the heart.

    PAPVR may be diagnosed soon after birth. Other times, the condition is not discovered until later in life.

    Tests

    Tests are needed to diagnose partial anomalous pulmonary venous return (PAPVR).

    An ultrasound of the heart called an echocardiogram can sometimes confirm PAPVR. This test uses sound waves to make pictures of the beating heart. An echocardiogram often shows the pulmonary veins, the size of the heart chambers and any holes in the heart. It also measures the speed of blood flow.

    Sometimes, an echocardiogram may not detect PAPVR. Other tests such as a CT scan or MRI may be used.

    Treatment

    Most patients with partial anomalous pulmonary venous return (PAPVR) need surgery. Surgery to repair the heart may be needed if:

    • A lot of oxygen-rich and oxygen-poor blood mixes in the heart.
    • The right side of the heart is a lot larger than usual.

    If you don't have symptoms, surgery may not be needed. If surgery for another heart condition is needed, surgeons may repair PAPVR at the same time.

    There are several types of surgery for PAPVR. Together, you and your surgeon will talk about the best options. During repair surgery, the heart surgeon will:

    • Reconnect the pulmonary veins to the left upper heart chamber.
    • Close any holes in the heart.

    A person with partial anomalous pulmonary venous return needs regular health checkups for life to check for complications. It's best to see a doctor who is trained in congenital heart diseases. This type of doctor is called a congenital cardiologist.
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    1. Fulton DR, et al. Partial anomalous pulmonary venous return. https://www.uptodate.com/contents/search. Accessed Sept. 16, 2024.
    2. Libby P, et al. eds. Congenital heart disease in the adolescent and adult. In: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2022. Accessed July 31, 2024.
    3. Kliegman RM, et al. Acyanotic congenital heart disease: Left-to-right shunt lesions. Nelson Textbook of Pediatrics. 22nd ed. Elsevier; 2025. https://www.clinicalkey.com. Accessed Sept. 16, 2024.
    4. What are congenital heart defects? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/congenital-heart-defects. Accessed July 31, 2024.
    5. Bravo-Vaenzuela NJM, et al. Prenatal diagnosis of total anomalous pulmonary venous connection: 2D and 3D echocardiographic findings. Journal of Clinical Ultrasound. 2021; doi:10.1002/jcu.22973.
    6. El-Kersh K, et al. Partial anomalous pulmonary venous return: A case series with management approach. Respiratory Medicine Case Reports. 2019; doi:10.1016/j.rmcr.2019.100833.
    7. Overview of congenital cardiovascular anomalies. Merck Manual Professional Version. https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/overview-of-congenital-cardiovascular-anomalies. Accessed Aug. 4, 2024.
    8. Congenital heart defects in children. https://www.mayoclinic.org/diseases-conditions/congenital-heart-defects-children/symptoms-causes/syc-20350074. Accessed Aug. 4, 2024.
    9. Medical review (expert opinion). Mayo Clinic. Oct. 1, 2024.

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