Unmasking a Missed Left-sided Partial Anomalous Pulmonary Venous Return and Residual Atrial Septal Defect a Decade after Device Closure: Integrated Surgical Repair with Coronary Bypass

Key Points

• This case highlights the late diagnosis of residual ASD and PAPVR occurring after device closure. It emphasizes the need for detailed pre-procedural evaluations.
• Documented the case of a patient with residual ASD and PAPVR identified after previous closure.
• Performed comprehensive imaging to uncover significant anomalies and stenosis.
• Executed a single-stage surgical procedure combining ASD closure, PAPVR rerouting, and coronary bypass.
• Surgical intervention successfully corrected the residual ASD and re-routed PAPVR in a single procedure.
• The patient also received coronary artery bypass grafting to address the significant LAD artery stenosis.
• Thorough pre-surgical assessment revealed the unmasked congenital anomalies, demonstrating limitations of standard imaging.