CTICasesLevoatrial Cardinal Vein with Anomalous Pulmonary Venous Return
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Imaging findings
CT imaging reveals a vessel located to the left of the aorta, initially resembling a left superior vena cava or anomalous pulmonary vein. This vessel is identified as an anomalous pulmonary venous connection that continues down into the expected location of the left superior pulmonary vein and then into the left atrium.
Key takeaways
A levoatrial cardinal vein is a rare congenital venous anomaly, typically seen in association with congenital heart disease (e.g., hypoplastic left heart with absence of an atrial septal defect), where it acts as an outflow for the left atrium. In isolation, or combined with anomalous pulmonary venous return, it can cause shunting, often left-to-right, and may become symptomatic (e.g., TIAs during coughing spells due to bidirectional shunting).
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