The fistulous connection between the anomalous vein and a normal coursing right
inferior pulmonary vein provides an uncommon pathway for a paradoxical embolus depending on the direction of flow in the main scimitar vein.
The caliber change between the common trunk and the
inferior pulmonary vein was marked.
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.
During this procedure, nodules from the upper lobe, the posteriorly situated segment of the left lower lobe, and the
inferior pulmonary ligament were removed.
It has been shown that physiologically the muscular wall of the left atrium may extend up to a few centimeters around the pulmonary veins, more so in the superior than the
inferior pulmonary veins.
The CACAF ablation strategy involved circumferential isolation of all pulmonary vein ostia and creation of two linear lesions, one along the isthmus between the left
inferior pulmonary veins and the mitral annulus, the other in the right atrium between the inferior vena cava and tricuspid annulus.