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Cannulating the CS in patients with PLSVC. (A) In this case, the patient has a PLSVC and the CS is greatly dilated. However, the great cardiac vein as shown in fluoroscopy remains its normal size. (B) An occlusive venogram performed above the Vieussens valve identifies target veins both above and below the valve. (C) Selective injection of contrast in the middle cardiac vein is another approach to identify target branches. CS, coronary sinus; PLSVC, persistent left superior vena cava
