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What is"Buffalo aorta"?
Maybe "Bovine aorta"?
RSA origins from BC trunk on right, you think about LCCA from innominate artery? Common origin?

Its left. Dao -LA append -and Left vein.. :) mb Imn't right(( ? "Lost in translation" - ? :D "- It seems probably right,then we have consensus" - Its left..." (c) Most likely that the pronoun "It" in this context substitutes not the noun "vein", but the ...

It seems probably right,then we have consensus

left upper pulmonary vein?

This is the thing we are talking about with Pawel, maybe this blue flow is arteriosus,we see it often.

Understood, I can see LA isomerism in TTE with a good acustic window.Back to the picture:
What is the blue flow ,venous flow, along AoDesc,on the left,first picture?

In my opinion subcostale view with isomerism of IVC left sided and polisplenia is a evidence.
Accessory evidence maybe presence of atrial appendage isomerism, I think about left atrial appendage isomerism of right atrial.
https://www.youtube.com/watch?v=TnfHdZrmMAw

Amazing, I have never seen it before.Alexandr could you spell it in English,pls? These four possibilities: - Left upper pulmonary vein-> vertical vein-> BCV sin - Left intercostalis superior vein-> BCV sin - Left internal thoracis vein-> BCV sin - Hemiazygos ,accessory HAZ vein-> BCV sin direction W...

any intervention?
Surgical or endovascular intervention? Flow from left innominate vein to right BCV and SVC ?

Left o right sided aortic arch?
PDA is for sure,if no intervention there were.Normal, left sided aortic arch?

Whole heart Echo,nothing impressive too much,LV diastolic- 64mm,IVS-14 mm,EF-40-45%,Diastolic dysfonction/relaxation- I degree.Nothing special I think the secret is in inherited arch anomaly, double lumen aortic arch ?double barreled aorta desc? Persistent V th arch? I think about this superior vess...

One flow is a secret, on the left side on a monitor, blue-red.Below BCV sin

Taking Nr 1 vessel- red one with inlow brachiocephalic vain sin,3 possibillities:
normal/variant- left supracostal vein or left thoracic internal vein
Anomaly- anomalous left upper pulmonary vein or veins-> verticale vein-> brachiocephalic vein.BCV sin

Thx a lot,Alexandr, according to your attitude- isolated MAPCA in adult,rear rarity in adult without any heart desease

Everybody knows this triphasic flow- 2 waves above,here in fusion ,and one under baseline- this is typical pattern of pulmonary vein flow.
Vertical vein is only aconduit here, the first is anomalous left upper pulmonary vein.