Author + information
- Received January 19, 2012
- Accepted January 31, 2012
- Published online October 2, 2012.
A 9-year-old girl with a history of aortic coarctation, large ventricular septal defect (VSD), patent ductus arteriosus, and bicuspid aortic valve had previously undergone neonatal coarctation repair with ductal ligation followed by VSD closure at 4 years. Follow-up echocardiography revealed new right atrial and ventricular dilation with a prominent vein entering the left brachiocephalic vein (LBCV). Three-dimensional (3D) magnetic resonance angiography (A) and 4D flow magnetic resonance imaging (MRI) (B, Online Video 1) provide comprehensive anatomic evaluation and 3D hemodynamics with a left-to-right shunt flow pathway via a levoatriocardinal vein (LACV) draining the left atrium (LA) to the LBCV, superior vena cava (SVC), and right atrium (RA). The calculated ratio of pulmonary to systemic flow was 1.3:1. LACV is a rare, persistent venous connection between the LA and cardinal vein system (here, the LBCV) and is associated with obstructive lesions such as coarctation (1). LPV = left pulmonary vein; LV = left ventricle; RPV = right pulmonary vein; RV = right ventricle.
Dr. Rigsby has received an institutional research agreement with Siemens Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 19, 2012.
- Accepted January 31, 2012.
- American College of Cardiology Foundation