Fig. 1

Left: Color study TEE with an upper esophageal view illustrates flow (green arrow) from RUPV (blue) to SVC (orange). The red arrow indicates the ascending aorta; right: Contrast study with the upper esophageal view highlights the ascending aorta (green arrow), the SVC filled with contrast (red arrow), and negative contrast (yellow arrow) caused by flow from the RUPV (blue arrow)