Two unique systemic venous connections of levoatriocardinal vein without intracardiac anomalies

Levoatriocardinal vein is a rare venous anomaly occasionally presenting as a bidirectional shunt in structurally normal hearts. We describe two unique systemic connections of levoatriocardinal vein without intracardiac defects, one causing paradoxical embolism via the hemiazygos vein, and the other draining from the left jugular vein to the pulmonary vein, requiring surgical correction to preserve cerebral venous return.