A Rare Levoatrial Cardinal Vein Connecting the Left Inferior Pulmonary Vein to the Inferior Vena Cava

A 59-year-old woman presented with chest tightness for 2 weeks.Physical examination revealed a grade 2/6 ejection systolic murmur best heard in the second and third left intercostal spaces.Laboratory tests revealed significantly elevated levels of NT-proBNP 8590 pg/mL (reference range <125 pg/mL).Transthoracic echocardiography showed a bicuspid aortic valve with severe stenosis; left ventricular (LV) dilatation and LV systolic dysfunction with ejection fraction value of 32%.The maximum intensity projection of computed tomography angiography (CTA) and image showed a levoatrial cardinal vein (LACV) connecting the left inferior pulmonary vein (LIPV) to the inferior vena cava (IVC) (Figure 1A andB).