Multiple anomalies of caval veins in a patient with pulmonic stenosis.

Anomalies of the supra-diaphragmatic portion of the inferior caval vein are rare in patients with normal sinus. We recently encountered a patient with situs solitus and infundibular pulmonic stenosis who had bifurcation of the supra-diaphramatic portion of the inferior caval vein with anomalous high insertion of one portion into the mid-right atrium. The other division joined the coronary sinus which also received a persistent left superior caval vein and left hepatic veins. Biplane angiography was used to delineate the anatomy. Pre-operative delineation is required as this anomaly complicates cardio-pulmonary bypass.