Morfologia kliniczna wad spływów żył płucnych i systemowych

Abnormal pulmonary and systemic venous return is a heterogeneous group of congenital heart defects. Part of them are incidental findings, even in adulthood, and they have little haemodynamic significance. The other ones are isolated anomalies or they associate different cardiac malformations. In those cases they need to be treated in newborns or infants. Normal venous development is a process of progressive appearance of paired venous structures, development of anastomoses between them and selective regression of certain segments. Initially, three major veins drain into each horn of sinus venosus: vitelline vein, common cardinal vein and umbilical vein. Their transformations lead to formation of caval veins, coronary sinus and part of the atrial wall. A left-sided superior vena cava draining into the coronary sinus is the most common systemic venous anomaly. Nevertheless, the most common venous malformation involving the inferior vena cava is absence of its suprahepatic segment, with azygos vein continuation. The development of the pulmonary venous system is of significance, considering the co-existence of anomalies of pulmonary and systemic venous drainage. Anomalous pulmonary venous connection take various forms. In morphological point of view partial and total anomalous pulmonary venous return are known. Each of them is classified as a supracardiac, cardiac, infradiaphragmatic or infracardiac and mixed type. The knowledge of embryology and anatomy is helpful in understanding of genesis and haemodynamics of above malformations, as well as in therapy decisions.