Baffle thrombosis in an adult with remote prior scimitar vein repair mimicking massive pulmonary embolism

Clin Imaging. 2014 Jul-Aug;38(4):518-521. doi: 10.1016/j.clinimag.2014.03.007. Epub 2014 Mar 22.


A 58-year-old man with a history of Scimitar syndrome diagnosed and surgically repaired in early adulthood presented multiple times to the emergency department complaining dyspnea, chest pain, and hemoptysis. Asymmetric pulmonary arterial flow rates between left and right lungs resulted in an apparent filling defect on computed tomographic pulmonary arteriography, which was repeatedly misdiagnosed clinically and radiologically as a massive pulmonary embolus. This case highlights the importance of understanding the pathophysiology and post-surgical complications of repaired congenital cardiovascular disease. Delayed phase acquisitions are often necessary to characterize the physiology of repaired congenital cardiovascular disease with associated shunts.

Keywords: Artifact; Baffle thrombosis; Computed tomography pulmonary angiography; Pulmonary embolus; Scimitar syndrome.

Publication types

  • Case Reports

MeSH terms

  • Artifacts
  • Dyspnea / etiology
  • Humans
  • Lung / diagnostic imaging*
  • Male
  • Middle Aged
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Embolism / diagnostic imaging*
  • Scimitar Syndrome / diagnostic imaging*
  • Thrombosis / diagnostic imaging*
  • Tomography, X-Ray Computed*
  • Treatment Outcome