A rare variant of mixed total anomalous pulmonary venous connection with a garland configuration of the azygous system: Expanding the spectrum of anatomical variants

Mixed-type total anomalous pulmonary venous connection (TAPVC) is the least common variant in Darling’s classification and is further subdivided into three distinct subtypes. We report an exceptionally rare mixed TAPVC with a 2 + 2 drainage pattern, associated with an unusual venous anomaly in which the hemiazygos vein drains into the innominate vein, forming a characteristic “garland” configuration.