New Fetal Sonographic Marker to Rule Out Total Anomalous Pulmonary Venous Return: Color Doppler Drainage From Pulmonary Vein to Atrium to Ventricle (CDDVAV)

Many cases of total anomalous pulmonary venous return (TAPVR) present with life-threatening pulmonary venous obstruction within hours following delivery. As a result, prenatal detection represents an important approach to optimizing outcome. Unfortunately, TAPVR remains one of the most challenging major forms of congenital heart disease to detect prenatally; most cases elude diagnosis until postnatal life, despite the widespread recognition of multiple fetal two-dimensional (2D) and color Doppler sonographic markers. This commentary demonstrates that even the 2D and color Doppler appearance of pulmonary venous drainage to the left atrium may be seen in cases of TAPVR. Accordingly, we describe, for the first time, a novel color Doppler fetal sonographic marker to rule out TAPVR.