CLINICAL DATA Infant, 11-month-old, male, diagnosis of Tetralogy of Fallot with retrotracheoesophageal course of the brachiocephalic vein. Usual findings of Tetralogy of Fallot on physical examination. Technical description: Chest radiography showed slightly reduced pulmonary vascular markings and no cardiomegaly. Normal preoperative electrocardiogram with postoperative right bundle branch block. Usual findings of Tetralogy of Fallot on echocardiogram. Postoperative computed tomography angiography confirmed left brachiocephalic vein with anomalous retrotracheoesophageal course, configuring a U-shaped garland vein, in addition to postoperative findings of total correction of Tetralogy of Fallot. OPERATION Complete surgical repair was performed with pulmonary valve commissurotomy and placement of bovine pericardial patch to solve right ventricular outflow tract obstruction, pulmonary trunk enlargement, and ventricular septal defect closure. COMMENTS Systemic venous drainage may show variations in patients with Tetralogy of Fallot. These abnormalities are usually of little clinical relevance, as they are asymptomatic. We presented a rare case of retrotracheoesophageal course of an anomalous left brachiocephalic vein with intraoperative diagnosis, confirmed by imaging during postoperative follow-up, without compromising clinical management or surgical approach.

中文翻译：

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法洛四联症伴头臂静脉异常走向。

临床数据 婴儿，11 个月大，男性，诊断为法洛四联症，伴有头臂静脉气管食管后走行。法洛四联症体检的常见结果。技术描述：胸部X线检查显示肺血管纹理略有减少，无心脏扩大。术前心电图正常，术后右束支传导阻滞。法洛四联症超声心动图的常见表现。术后计算机断层扫描血管造影证实左头臂静脉气管食管后走行异常，形成 U 形花环静脉，此外法洛四联症术后完全矫正。手术 通过肺动脉瓣连合切开术和放置牛心包补片进行完整的手术修复，以解决右心室流出道阻塞、肺干扩大和室间隔缺损闭合问题。评论 法洛四联症患者的全身静脉引流可能表现出差异。这些异常通常没有什么临床意义，因为它们是无症状的。我们提出了一个罕见的左头臂静脉异常气管食管病程的病例，并在术中进行了诊断，并在术后随访期间通过影像学证实，且不影响临床治疗或手术方法。