Sinus venosus defect with 5th right pulmonary vein connecting to superior caval vein

A 61 year old women from Albania suffered from dyspnea NYHA II-III and frequent palpitations. The echocardiogram showed suspicion of sinus venosus defect and abnormal pulmonary venous return. Here is the CMR study of that women.

This T1 weighted black blood images shows the sinus venosus defect with blood flowing directly from the upper right pulmonary vein into the right atrium.
This contrast enhanced FFE image shows contrast in the superior caval vein and blood supplied from a 5th right pulmonary vein. The shunt was calculated with QF and analysed with FLOW from www.medis.nl. The shunt volume was 1:4.2. 
View some mpg files Video 1 
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