Unusual case with venous channels connecting the left and the right brachiocephalic veins/Sol ve sag brakiyosefalik venleri baglayan venöz kanallari olan olagandisi vaka

A 55-year-old female patient was admitted to the cardiology clinic with complaint of chest pain. She had no known any conspicuous medical history. Physical examination, electrocardiogram, echocardiography and all biochemical values were in normal range. Chest roentgenogram revealed suspicious mediastinal mass. The computed tomography displayed that the veins were visible and ran in the anterior mediastinum as a venous tuftfrom brachiocephalic veins (Fig. 1 and Video 1. See corresponding video/movie images at www.anakarder. com). Thymus gland, vessel structures or any other tissue was not observed in the venous tuftregion or in the mediastinum. The possibility of vascular access flow reduction was discussed with our patient and surgeons, but because of the absence of fistula, cardiovascular anomaly and patient remained asymptomatic, we decided to follow up patient for future symptoms. These malformations have importance at implantation of catheter and pacemaker. If this kind of malformation was bypassed, they can accidentally conclude or damage during surgery and may lead to serious hemorrhage. Also, they may obscure the surgical field or confused with other vessels.

Acknowledgement

We wish to express our sincere thanks to Dr. Sibel Yazgan (Department of Radiology, Atatürk State Hospital, Düzce - Turkey) and Dr. Engin Ersin Simsek (The Provincial Health Director of Düzce-Turkey) for their kindly provided the data necessary for our analysis and assisted with the preparation and proof-reading of the manuscript.

Video 1. Image of brachiocephalic vein malformation by threedimensional computed tomography.