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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">97</journal-id>
      <journal-id journal-id-type="index">urn:lsid:arphahub.com:pub:B5033382-9D21-53CE-B630-B4E3A1146D51</journal-id>
      <journal-title-group>
        <journal-title xml:lang="en">Bulgarian Cardiology</journal-title>
        <abbrev-journal-title xml:lang="en">Bulgarian Cardiology</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">1310-7488</issn>
      <issn pub-type="epub">2683-1015</issn>
      <publisher>
        <publisher-name>Bulgarian Society of Cardiology</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3897/bgcardio.28.e81592</article-id>
      <article-id pub-id-type="publisher-id">81592</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
        <subj-group subj-group-type="scientific_subject">
          <subject>Cardiovascular Imaging (сърдечно-съдови образни изследвания)</subject>
          <subject> Pediatric Cardiology (детска кардиология)</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Rare case of a mixed type total anomalous pulmonary venous return – benefits of a patient specific 3D model in the preoperative preparation</article-title>
      </title-group>
      <contrib-group content-type="authors">
        <contrib contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Dobrev</surname>
            <given-names>Dobri</given-names>
          </name>
          <email xlink:type="simple">dobrev.dobry@gmail.com</email>
          <uri content-type="orcid">https://orcid.org/0000-0002-8493-1130</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Kaneva</surname>
            <given-names>Anna {"bg": ""}</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Lazarov</surname>
            <given-names>Stojan</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Velkovski</surname>
            <given-names>Ivan</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Dineva</surname>
            <given-names>Svetla</given-names>
          </name>
          <uri content-type="orcid">https://orcid.org/0000-0002-5163-4631</uri>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>
        <addr-line content-type="verbatim">National Cardiology Hospital, Sofia, Bulgaria</addr-line>
        <institution>National Cardiology Hospital</institution>
        <addr-line content-type="city">Sofia</addr-line>
        <country>Bulgaria</country>
      </aff>
      <author-notes>
        <fn fn-type="corresp">
          <p>Corresponding author: Dobri Dobrev (<email xlink:type="simple">dobrev.dobry@gmail.com</email>).</p>
        </fn>
        <fn fn-type="edited-by">
          <p>Academic editor: Margarita Tzonzarova</p>
        </fn>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>06</day>
        <month>04</month>
        <year>2022</year>
      </pub-date>
      <volume>28</volume>
      <issue>1</issue>
      <fpage>144</fpage>
      <lpage>153</lpage>
      <uri content-type="arpha" xlink:href="http://openbiodiv.net/25348902-4129-55C4-8DF3-DABF4405DAE2">25348902-4129-55C4-8DF3-DABF4405DAE2</uri>
      <history>
        <date date-type="received">
          <day>02</day>
          <month>02</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>22</day>
          <month>03</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>Dobri Dobrev, Anna Kaneva, Stojan Lazarov, Ivan Velkovski, Svetla Dineva</copyright-statement>
        <license license-type="creative-commons-attribution" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <abstract>
        <label>Abstract</label>
        <p>Accurate imaging of the morphology in a child with a rare and complex congenital heart disease (CHD) is crucial for the surgical planning and, if possible – the minimization of operative risk. We present a case of a 3-month-old child with a rare variant of Total Anomalous Pulmonary Venous Return (TAPVR) – mixed type – which illustrates the beneﬁ t of additional imaging modalities and techniques for the operative planning. The patient’s anomalous drainage of the pulmonary veins (PV) is as follows: left and right lower PVs drained in the coronary venous sinus, left upper PV drained via a vertical vein into the innominate vein and the right upper PV drained into the superior vena cava (SVC). Clinical ﬁ ndings consist of heart failure (HF), pulmonary venous congestion and mild hypoxemia developing within the ﬁ rst days after birth. Transthoracic echocardiography (TTE) demonstrates the features of TAPVR, but the modality is unable to differentiate all of the described anatomic details. Accurate morphological diagnosis is obtained via contrast Computed Tomography (CT). The. additional techniques of 3D modelling and 3D printing of a patient-speciﬁ c model, based on the acquired CT, contributed to the planning of the surgical strategy. The patient underwent a radical operation at age of 3 months. The unique aspect of the case is the application of all possible operative techniques for correction of TAPVR – coronary sinus derooﬁ ng, anastomosis of a draining vessel into the left atrial appendage and Warden procedure which involves tunnelling of the right upper PVs from the SVC into the left atrium. Feedback from the surgical team shows that the additional imaging methods and the printed 3D model represent the pathology in detail that completely corresponds to the intra-operative ﬁ ndings</p>
      </abstract>
    </article-meta>
  </front>
</article>
