CTICasesTransmediastinal Anomalous Venous Drainage with Coarctation of the Aorta
Imaging findings
Chest CT and MRA demonstrate a repaired coarctation of the aorta with an indwelling aortic stent. A persistent left-sided anomalous vertical vein communicates with the left brachiocephalic vein. This vertical vein courses caudally, crosses the midline in the subcarinal space, and receives anomalous pulmonary veins from the left lung and the right inferior lung before ultimately draining into the right atrium.
Key takeaways
Complex transmediastinal anomalous venous drainage represents a rare vascular anomaly where pulmonary veins from one lung cross the midline to join contralateral venous channels or systemic veins. These pathways can coexist with other congenital cardiovascular anomalies, such as coarctation of the aorta, and require highly detailed anatomical mapping via gated cardiac CT or MRA.
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