Figure Legends
Figure 1. The echocardiographic image in the apical 4 chamber view shows both atrial appendages to be morphological left (red asterisks). Note the dilated coronary sinus (CS). The inset shows the subcostal axial view, revealing a venous channel (yellow asterisk) coursing posterior to the descending thoracic aorta (red asterisk). This is the interrupted inferior caval vein. The atrioventricular connections are mixed with right-handed ventricular topology (RV and LV). The modified high parasternal view in panel B shows the continuation of the inferior caval vein through the azygos vein to the left superior caval vein. Abbreviations : LA, left atrium; LSCV, left superior caval vein; LV, left ventricle; RA, right atrium; RV, right ventricle]
Figure 2: Volume rendered images (A, anterior view, and B, left anterior oblique view) in a patient with right isomerism showing both appendages to be morphologically right (*right sided morphologically right appendage, **left sided morphologically right appendage). Panel C, showing a posterior view, and panel D, a right lateral view, show the all four pulmonary veins draining at the junction of superior caval vein (SCV) with right atrium (RA) (black arrow in D).]
Figure 3: Axial computed tomographic images in a patient with right isomerism show, in panel A, a transverse midline liver. Panel B shows bilateral right bronchial morphology. The coronal image in panel C shows bilateral superior caval veins, each draining to its own atrium (R: right-sided morphologically right atrium; L: left-sided morphologically left atrium). The volume rendered images in panels D and E show the right-sided (*) and left-sided appendages (**), both morphologically right. As seen in panel F, all pulmonary veins (arrowheads) drain to the right-sided atrium
Figure 4: The volume rendered images, shown in panel A in right anterior oblique view, in panel B in left anterior oblique view, and in panel C in posterior view, show bilateral appendages of right morphology, with all pulmonary veins joining the right-sided atrium. Abbreviations: RA: right-sided atrium; LA: left-sided atrium; RV: right ventricle; LV: left ventricle; RSPV: right superior pulmonary vein; RIPV: right inferior pulmonary vein; LSPV: left superior pulmonary vein; LIPV: left inferior pulmonary vein, *right sided morphologically right atrial appendage, **left sided morphologically right atrial appendage]
Figure 5: Panels A and B show axial images, and Panels C and D show volume rendered images from a patient with right isomerism and pulmonary atresia. All the pulmonary veins (indicated by arrowheads) are connected to the right-sided atrium with a morphologically right appendage (RA). Note the co-existing defect in the oval fossa (white asterisk in B) and the perimembranous ventricular septal defect (black asterisk in B and C). Oblique axial image, as seen in panel E, shows pulmonary atresia (black arrow) with good-sized confluent pulmonary arteries. Oblique coronal image, seen in panel F, shows a patent arterial duct (indicated by star) feeding the pulmonary arteries. Abbreviations : RAA: right atrial appendage; LA: left-sided atrium; RV: right ventricle; LV: left ventricle; LPA: left pulmonary artery; RPA: right pulmonary artery.]
Figure 6:  Panel A shows a coronal image, and panel B a volume rendered image, from a patient with left isomerism. There is azygos continuation of the inferior caval vein, with the azygous vein (*) draining into the superior caval vein (SCV). Panels C through E show volume-rendered images subsequent to repair using the Kawashima procedure, with the superior caval vein connected to the pulmonary arteries. Abbreviations : RPA: right pulmonary artery; LPA: left pulmonary artery.
Figure 7: Panel A is an axial image from a patient with left isomerism, showing multipler spleens (yellow circle). The coronal minimal intensity projection image in panel B shows left bronchial isomerism. The volume rendered images seen in panel C, an anterior view, shows the hepatic veins (arrowed) draining into the right-sided atrium, which has a morphologically left appendage. Panel D, a sagittal image, demonstrates azygos (*) continuation of the inferior caval vein into the superior caval vein (SCV).
Figure 8: The volume rendered image (Panel A) from a patient with left isomerism shows hemiazygos (black arrows) continuation of the inferior caval vein into the left-sided superior caval vein (LSCV), which has been anastomosed to the pulmonary artery. Panel B shows separate hepatic veins (arrowheads) rerouted to the right pulmonary artery (RPA) via a graft (*). The maximum intensity projection image in panel C shows a pulmonary arteriovenous malformation (thick white arrow) in the left lower lobe.
Figure 9: The volume rendered image (Panel A) and the oblique coronal images (Panels B and C) are from a patient with left isomerism in whom the left-sided superior caval vein (LSCV) has been anastomosed to the left pulmonary artery (RPA). The hepatic veins (arrowheads) and the inferior caval vein have been connected to the right pulmonary artery (RPA) via a conduit whiuch is partly extracardiac and partly interatrial.
Figure 10: The volume rendered images, shown in a posterior view (panel A), a left anterior oblique view (panel B), and an anterior view (panel C), are from a postoperative patients with left isomerism who developed pulmonary arteriovenous malformations. There is hemizaygos (*) continuation of the inferior vena cava into the superior caval vein (SCV), which in turn has been anastomosed to the pulmonary arteries. The maximum intensity projection image in panel D shows a pulmonary arteriovenous malformation (yellow arrow) in the left lower lobe. Abbreviations : RPA: right pulmonary artery; LPA: left pulmonary artery.