OPEN ACCESS Freely available online Case Report 1 J Vasc Med Surg, Vol.8 Iss. 1 No: 388 Journal of Vascular Medicine & Surgery J o u r n a l o f V a s c ul a r M e d i c i n e & S u r g e r y ISSN: 2329-6925 Bilobectomy in a 49 Years Man Presenting Hemoptysis Associated to a Partial Anomalous Pulmonary Venous Return: A Case Report Mahdi Abdennadher* 1 , Mariem Hadj Dahmane 1 , Hazem Zribi 1 , Imen Bouassida 1 , Sarra Zairi 1 , Sawsan Hantous 2 , Aida Ayadi Kaddour 3 , Hanen Smadhi 4 , Sonia Ouerghi 5 , Taher Mestiri 5 , Adel Marghli 1 1 Service de chirurgie thoracique et cardiovasculaire, Hôpital Abderrahmane Mami, Ariana, Tunisia; 2 Service de radiologie. Hôpital Abderrahmane Mami, Ariana, Tunisia; 3 Service d’anatomopathologie, Hôpital Abderrahmane Mami, Ariana; 4 Service de Pneumologie, Ibn Nafis, Hôpital Abderrahmane Mami, Ariana, Tunisia; 5 Service d’anesthésie réanimation, Hôpital Abderrahmane Mami, Ariana, Tunisia ABSTRACT Partial Anomalous Pulmonary Venous Connection (PAPVC) is a rare congenital abnormality characterized by drainage of one or more pulmonary veins to the right atrium or to one of the systemic veins. This pathology has low prevalence, although it is probably underestimated and is rarely diagnosed in adults. We reported a rare case of hemoptysis in adult associated to isolated partial anomalous pulmonary venous return. He is a patient of 49 years-old man who had a partial anomalous pulmonary venous connection (PAPVC) from the right upper lobe to the superior vena cava without other congenital heart disease. A right bilobectomy (superior and middle lobe) was performed for the treatment for hemoptysis and PAPVC. The patient has an uneventful postoperative recovery and remained well at follow-up 8 months after surgery. Keywords: Hemoptysis; Partial anomalous pulmonary venous connection; Surgery INTRODUCTION Partial anomalous pulmonary venous connection (PAPVC) is a rare cardiac anomaly (less than 1% of all congenital cardiac defects). The diagnosis can be incidentally identified on imaging. It occurs when one or more of the pulmonary veins drain into the right atrium, coronary sinus or a systemic vein. Its prevalence is approximately 0.4%-0.7% in the general population [1,2], 10% of cases described on the left-sided [1]. The commonly site of anomalous connection is the superior cava vena (SVC) and in rare cases the azygous vein is involved [2]. We present a rare case of massive hemoptysis due to PAPVC with anomalous connection of the right upper lobe to the SVC; with the presence of a left superior cava vena was drained directly into the coronary sinus. The aim of our observation was to show that hemoptysis can be a revealing sign of PAPVC rather than recurrent bronchopulmonary infection in some cases and to demonstrate that lung resection can be effective treatment. CASE REPORT A 49-year-old man with a remote smoking history (30 packs cigarettes/year) and without significant past medical history was admitted for management of hemoptysis that started 3 days before. There was no context of alteration of the general condition, exercise intolerance, orthopnea, or chest pain. The patient was hemodynamically stable. Vital signs at the time of hospital admission are as follows: temperature 37.2°C; heart rate 88 beats/min; blood pressure 119/65 mm Hg; respiratory rate 20 breaths/min; and oxygen saturation 96% on room air. Chest examination showed clear breath sounds bilaterally. There was no jugular venous distention. Physical examination did not reveal marked abnormalities or evidence of vascular shunt. Abdominal and cardiac exams were unremarkable. Laboratory studies found hemoglobin of 10.3 g/dL, hematocrit: 40.7%, without thrombocytopenia or coagulopathy. Chest radiograph was normal. An emergency bronchoscopy showed active bleeding from the upper lobe, stigmas of bleeding at the level of the whole bronchial tree, diffuse inflammation of the bronchial mucosa. It showed, also, telangiectasia especially at the level of the trachea and the right bronchial tree. The Chest computed tomography (CT) revealed a partial anomalous venous *Correspondence to: Mahdi Abdennadher, Service de chirurgie thoracique et cardiovasculaire, Hôpital Abderrahmane Mami, Ariana, Tunisia, Tel: 21652166741; E-mail: abdennadhermahdi@gmail.com Received: November 21, 2019; Accepted: March 12, 2020; Published: March 18, 2020 Citation: Abdennadher M, Dahmane MH, Zribi H, Bouassida I, Zairi S, Hantous S, et al. (2020) Bilobectomy in a 49 years man presenting Hemoptysis associated to a Partial Anomalous Pulmonary Venous Return: A Case Report. J Vasc Med Surg 8:388. doi: 10.35248/2329-6925.20.8.388. Copyright: © 2020 Abdennadher M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.