Pre-operative, dual phase cardiac CT has made it possible to provide the surgeon with all the necessary details to plan immediate surgery in early infancy with an accurate roadmap of pulmonary venous anatomy, tremendously improving the outcome of this otherwise complex and challenging condition.

The length and size of individual veins, as well as the presence of anatomic osteal narrowing, are more significant factors in determining the degree of surgical complexity than just the venous drainage pattern. The surgery must be tailored in each patient based on the type of drainage pattern, flow obstruction and other additional cardiac and vascular anomalies.