Impact of Fetal Diagnosis on the Management of Right Superior Vena Cava to Left Atrium

Prenatal diagnosis of cardiac defects can significantly aid postnatal care. We present 2 cases of a rare anomaly of the right superior vena cava draining into the left atrium, one postnatally diagnosed and one prenatally diagnosed, to highlight the differences in care and the benefits of prenatal diagnosis. The patient who received the postnatal diagnosis was born at a community hospital with hypoxemia. There was a delay in diagnosis, which resulted in escalation of critical care support including the use of extracorporeal membrane oxygenation. The prenatally diagnosed patient presented with concern of a dilated left atrium in the fetus. After the diagnosis, there was coordinated delivery with cardiology presence and immediate transfer to the cardiac care center. This patient was stabilized using minimal support, had timely postnatal imaging studies, and successful surgical repair with an uncomplicated clinical course. Prenatal diagnosis resulted in coordinated high-quality care because of a shared cognitive framework.