An uncommon perspective on a common congenital anomaly

摘要

A 59-YEAR-OLD MAN with severe aortic stenosis presented for valve replacement surgery. After uncomplicated induction of anesthesia, an introducer was placed into the left internal jugular vein, through which a pulmonary artery catheter (PAC) was easily directed into the pulmonary artery on the first attempt. The intraoperative course was uneventful. On postoperative day 1 in the intensive care unit, the following chest x-ray was obtained (Fig 1). What is the diagnosis?