Fig. 19
From: Persistent left superior vena cava: clinical importance and differential diagnoses
Levoatriocardinal vein-2. Axial (a, b, c, f) and 3D VRT (d, e) CT images of a patient with double SVC (green and red arrows, a) and complex cardiac anomaly, who underwent bicaval Glenn shunt operation. Axial CT images (b, c) depict the thrombus extending from the right Glenn shunt to confluent pulmonary arteries (red stars). Due to the thrombus in the right Glenn shunt, the distribution of the contrast agent injected from the right arm into the mediastinal collaterals and the azygos system is observed. Axial (b, c) and 3D VRT reconstructed (d, e) CT images indicate bilateral vascular structures, which are compatible with LACV (blue arrows), originating from right Glenn shunt, coursing in the posterior of bilateral pulmonary arteries and draining into the right and left upper pulmonary veins. Please note that LACV may accompany LOLs (yellow arrow shows hypoplastic left heart, f), may be seen together with PLSVC, may be associated with any venous structure in the cardinal system not only left brachiocephalic vein, and in some cases, may have blood flow in the craniocaudal direction