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Anomalous cardiac venous system

During coronary artery bypass surgery on a 77-year-old man, an anomalous cardiac vein was noticed between the ascending aorta and pulmonary trunk (Figure 1). Postoperative 3-dimensional computed tomography (Figure 2) revealed that the great cardiac vein, isolated from the coronary sinus, ran leftward and posteriorly to the pulmonary trunk to merge with the small cardiac vein between the ascending aorta and pulmonary trunk, and drained into the left brachiocephalic vein.