Potential Clinical Implications of the “Aortic Collar” Configuration of an Anomalous Left Brachiocephalic Vein Amir Awwad, MBBCh, MRCS, Yutaro Higashi,

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Potential Clinical Implications of the “Aortic Collar” Configuration of an Anomalous Left Brachiocephalic Vein Amir Awwad, MBBCh, MRCS, Yutaro Higashi, MRCS, FRCR, Maruti Kumaran, MB, FRCR The Annals of Thoracic Surgery Volume 98, Issue 6, Pages e147-e149 (December 2014) DOI: 10.1016/j.athoracsur.2014.07.092 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A–C) Triggered computed tomographic pulmonary angiography through a contrast injection into the left arm. Starting at (A) the thoracic inlet, the axial slices demonstrate the enhanced left brachiocephalic collar configuration with (B) branching and (C) subsequent reforming above the azygous orifice of the superior vena cava (SVC). (A = aorta; Aa = ascending aorta; B = brachiocephalic vein; B1 = supraaortic branch; B2 = subaortic branch; C = azygous orifice, Da = descending aorta.) The Annals of Thoracic Surgery 2014 98, e147-e149DOI: (10.1016/j.athoracsur.2014.07.092) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Three-dimensional reconstruction with vascular segmentation of the central vasculature demonstrating the anomalous relationship of the vein and the aortic arch and pulmonary artery (PA). (A) Anterior view and (B) posterior view. (A = aorta; Aa = ascending aorta; B = brachiocephalic vein; B1 = supraaortic branch; B2 = subaortic branch; Da = descending aorta; PA = pulmonary artery; SVC = superior vena cava.) The Annals of Thoracic Surgery 2014 98, e147-e149DOI: (10.1016/j.athoracsur.2014.07.092) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions