41
Table 16. Comparison of Anomalous Pulmonary Venous
Connections With Atrial Septal Defect
Anomalous Pulmonary
Venous Connections
Atrial Septal
Defect
Shunt direction Le-to-right only Le-to-right,
right-to-le, or
bidirectional
Risk for paradoxical embolism No Yes
Risk for hypoxemia No Yes
Magnitude of shunt change over
time
No Yes
Right ventricular volume overload Yes Yes
Risk for pulmonary arterial
hypertension
Yes Yes
Transcatheter option No Yes
Table 17. Anomalous Pulmonary Venous Connections:
Routine Follow-Up and Testing Intervals
Type of Follow-Up
or Testing
Physiological
Stage A* (mo)
Physiological
Stage B* (mo)
Physiological
Stage C* (mo)
Physiological
Stage D* (mo)
Outpatient ACHD
cardiologist
36–60 24 6–12 3–6
Electrocardiogram 36–60 24
12 12
Transthoracic
echocardiogram
36–60 24 12 12
For recommendations on CMR and CT angiography, see Section 4.1.4 supportive text for
recommendations #1–3.
* See Section 2.2 for details on the ACHD anatomic and physiological classification system.
ACHD indicates adult congenital heart disease; CMR, cardiovascular magnetic resonance;
and CT, computed tomography.
