title: Anomalous course of the left brachiocephalic vein.
abstract: An anomalous course of the left brachiocephalic vein beneath the aortic arch was identified in 7 patients undergoing surgical repair of congenital cardiac malformations. Six of these patients had the morphologic features of tetralogy of Fallot including severe obstruction to the right ventricular outflow tract and a right aortic arch. A review of the literature reveals this to be an uncommon anomaly. When it is present, however, it is frequently associated with a ventricular septal defect, obstruction of the right ventricular outflow, and aortic arch anomalies. This anomaly can be documented by echocardiography, at cardiac catheterization, or intraoperatively. The presence of a subaortic left brachiocephalic vein may have implications for the conduct of surgical procedures, especially in the setting of tetralogy of Fallot.
authors.affiliation: Division of Cardiothoracic Surgery, University of North Carolina School of Medicine, Chapel Hill.
authors.forename: M R
authors.initials: MR
authors.lastname: Mill
authors.forename: B R
authors.initials: BR
authors.lastname: Wilcox
authors.forename: F C
authors.initials: FC
authors.lastname: Detterbeck
authors.forename: R H
authors.initials: RH
authors.lastname: Anderson
mesh_terms: D000015:Abnormalities, Multiple; D016121:Brachiocephalic Veins / Q000002:abnormalities*; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male