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What is on the presence
of an additional vessel identified to the left of the
pulmonary artery in the three-vessel view of the
heart.

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This is a concerning finding and very well could be a vertical decompressing vein related to anomalous pulmonary venous drainage. Pulmonary venous drainage is not "phasic" like systemic veins and the waveforms could appear arterial in nature if there is obstruction in the vertical decompressing vessel.

 

Hope that helps,

Joe Kreeger

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