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    Anderson, Robert H. Brown, Nigel A. and Mohun, Timothy J. 2016. Insights regarding the normal and abnormal formation of the atrial and ventricular septal structures. Clinical Anatomy, Vol. 29, Issue. 3, p. 290.

    Tretter, Justin T. Chikkabyrappa, Sathish Spicer, Diane E. Backer, Carl L. Mosca, Ralph S. Anderson, Robert H. and Bhatla, Puneet 2016. Understanding the spectrum of sinus venosus interatrial communications. Cardiology in the Young, p. 1.

    Crystal, Matthew A. Vincent, Julie A. and Gray, William A. 2015. The wedding cake solution: A percutaneous correction of a form fruste superior sinus venosus atrial septal defect. Catheterization and Cardiovascular Interventions, Vol. 86, Issue. 7, p. 1204.

    Anderson, Robert H. Spicer, Diane E. Brown, Nigel A. and Mohun, Timothy J. 2014. The Development of Septation in the Four-Chambered Heart. The Anatomical Record, Vol. 297, Issue. 8, p. 1414.

    Aramendi, José I. Cubero, Alain Hamzeh, Gadah and Rey, Estibaliz 2014. Cavopulmonary window: an extreme form of sinus venosus defect. Interactive CardioVascular and Thoracic Surgery, Vol. 18, Issue. 2, p. 253.

    Dyer, Kevin Todd Hlavacek, Anthony Marcus Meinel, Felix Gabriel De Cecco, Carlo Nicola McQuiston, Andrew Douglas Schoepf, Uwe Joseph and Pietris, Nicholas Peter 2014. Imaging in congenital pulmonary vein anomalies: the role of computed tomography. Pediatric Radiology, Vol. 44, Issue. 9, p. 1158.


Veno-venous bridges: the forerunners of the sinus venosus defect

  • Ryan J. Butts (a1), Andrew M. Crean (a2) (a3), Anthony M. Hlavacek (a1), Diane E. Spicer (a4) (a5), Andrew C. Cook (a6), Erwin N. Oechslin (a2) (a3) and Robert H. Anderson (a1) (a6)
  • DOI:
  • Published online: 24 May 2011

Differentiation of the so-called sinus venosus defect from other defects permitting shunting between the atrial chambers remains problematic. The lesion is not a true septal defect, and current theories to explain the existence of the sinus venosus defect fall short. The presence of persistent systemic to pulmonary venous connections has been proposed to explain the existence of the sinus venosus defect.


Clinical histories and radiological findings of six patients are reviewed. Three patients have veno-venous bridges, two have partial anomalous pulmonary venous connections, and one patient has a sinus venosus defect. The clinical information is reviewed, along with current developmental and morphological considerations.


We provide radiographic, developmental, and morphological evidence to support the theory that a so-called sinus venosus defect is the consequence of persistence of foetal systemic to pulmonary veno-venous bridges, rather than of deficiencies in atrial septation.

Corresponding author
Correspondence to: Dr R. Butts, Department of Pediatrics, Medical University of South Carolina, 171 Ashley Avenue, Charleston, South Carolina 29425, United States of America. Tel: 843 792 3286; Fax: 843 792 3284; E-mail:
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2.S Van Praagh , ME Carrera , SP Sanders , JE Mayer , R Van Praagh . Sinus venosus defects: unroofing of the pulmonary veins – anatomic and echocardiographic findings and surgical treatment. Am Heart J 1994; 128: 365379.

3.RH Anderson , S Webb , NA Brown . Clinical anatomy of the atrial septum with reference to its developmental components. Clin Anat 1999; 12: 362374.

4.MA Crystal , K Al Najashi , WG Williams , AN Redington , RH Anderson . Inferior sinus venosus defect: echocardiographic diagnosis and surgical approach. J Thor Cardiovasc Surg 2009; 137: 13491355.

6.WA Devine , RH Anderson . Superior caval to pulmonary venous fistula – the progenitor of the sinus venosus defect. Pediatr Pathol 1989; 9: 345349.

7.HJ Swan , JW Kirklin , LM Becu , EH Wood . Anomalous connection of right pulmonary veins to superior vena cava with interatrial communications: hemodynamic data in 8 cases. Circulation 1957; 16: 5466.

8.JA Ettedgui , RD Siewers , RH Anderson , SC Park , E Pahl , JA Zuberbuhler . Diagnostic echocardiographic features of the sinus venosus defect. Br Heart J 1990; 64: 329331.

10.S Van Praagh , ME Carrera , S Sanders , JE Meyer Jr, R Van Praagh . Partial or total direct pulmonary venous drainage to right atrium due to malposition of septum primum: anatomic and echocardiographic findings and surgical treatment: a study based on 36 cases. Chest 1995; 107: 14881498.

11.S Webb , NA Brown , A Wessels , RH Anderson . Development of the murine pulmonary vein and its relationship to the embryonic venous sinus. Anat Rec 1998; 250: 325334.

12.S Webb , NA Brown , RH Anderson , MK Richardson . Relationship in the chick of the developing pulmonary vein to the embryonic systemic venous sinus. Anat Rec 2000; 259: 6775.

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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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