This case highlights scimitar syndrome with a fistulous connection between the scimitar and normal coursing
inferior pulmonary vein. Surgical correction of the potential embolic pathway from this unique variant resulted in normal directed pulmonary flow and resolution of the associated left to right shunt.
The
inferior pulmonary vein should always be identified during left upper lobectomy.
1a-1e) settings at the level of
inferior pulmonary veins shows a nipple like structure (arrow) with enhancement similar to that of descending thoracic aorta at the mediastinal edge of the left basal lung segments, which on subsequent figures is shown to be an aberrant artery arising from the descending thoracic aorta.
Caption: Figure 3: 3D reconstruction of the cardiac MRI demonstrates marked narrowing of the right pulmonary artery (black arrowhead) and the right
inferior pulmonary veins (white arrowhead).
Occasionally there are accessory pulmonary veins, which are named on the basis of the pulmonary lobe that they drain, and present an independent atriopulmonary venous junction separate from the superior and
inferior pulmonary veins, without functional significance.