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Figure 4 A patient with dextrocardia and left atrial isomerism, azygous continuation of the right SVC, with left SVC draining to coronary sinus. A) After a BCPA, a balloon occlusion angiogram in the frontal projection is performed within the azygous vein (AZY) showing filling of a paravertebral plexus of veins (*). B) After deflating the balloon and advancing the catheter to the left renal vein (LRV), contrast enters a collateral channel (arrow) and hence (*) to portal vein (PV). The liver parenchyma drains via the hepatic veins to the common atrium. This child was profoundly cyanosed with an aortic oxygen saturation of 65% in 100% oxygen. Coil occlusion of the LRV-PV connection was performed with improvement in O2 saturation to 80% in air.
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