CTICasesCoarctation of Aorta with Meandering Pulmonary Vein
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Imaging findings
A 28-year-old presented with an endovascular stent for aortic coarctation, accompanied by subtle rib sclerosis and undulations. A tubular, sharply marginated structure, identified as a meandering pulmonary vein on CT angiogram, was also observed. This vein tracked down, looped back, and joined the inferior pulmonary vein into the left atrium, with no associated shunt or systemic connection at its superior aspect.
Key takeaways
Meandering pulmonary veins are typically seen on the right side and have been termed 'pseudo-scimitar sign'. Embryologically, pulmonary veins have systemic connections that usually regress; depending on the stage and level of regression, a spectrum of abnormalities can arise, including a 'scimitar variant' with communication to both the IVC and left atrium. This case, an incidental detection with no saturation difference on angiography, suggests preferential flow to the left atrium.
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