Aberrant left brachiocephalic vein.

Fig. 1. Magnetic resonance imaging was performed using a 1.5 T MRI scanner (Toshiba Medical Systems; Crawley, UK) with cardiac coil and ECG-gating. Noncontrast-enhanced MRA involved a fast-advanced spin-echo (FASE) sequence. The coronal image illustrates aberrant left brachiocephalic vein (arrowheads), which passes posterior to the left subclavian and common carotid arteries to join the right brachiocephalic vein (arrow). Identification of anomalous venous drainage is of clinical importance since the retro-aortic portion may be misinterpreted as an enlarged lymph node. The diagnosis will also have direct implications on the technique used to establish adequate venous drainage during cardiopulmonary bypass.