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First pass radionuclide angiography was used to demonstrate a leaking Glenn anastomosis at the superior vena cava--right atrial junction as well as tricuspid atresia and a ligated persistent left superior vena cava. First pass radionuclide angiography may demonstrate anatomic configurations not obvious at cardiac catheterization and can be useful for adults with complicated congenital heart disease, particularly when biplane or multiple view angiography is not possible. Lung perfusion imaging can lead to an incorrect diagnosis of pulmonary embolism if the presence of a Glenn anastomosis in not known.
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