Superior vena cava varix incriminating obstructive total anomalous pulmonary venous connection in a 42-day-old infant

We report a 42-day-old infant, who presented shortness of breath and remarkable cyanosis postprandially, with heterotaxy syndrome and complex congenital cardiovascular malformations. We deemed that the occurrence of the varix of the superior vena cava (SVC) may be related to the obstructive total anomalous pulmonary venous connection (TAPVC) with turbulent jet via the stenotic orifice to the wall of the SVC. Intravenous prostaglandin E1 unmasks obstruction of the TAPVC in our patient. We correlated the clinical features with the radioimaging findings of the plain chest film, the echocardiography, the angiocardiography, and the electron beam computed tomography (CT) of the chest, and ascribed the morphogenesis of the varix of the SVC to obstructive TAPVC in this infant.