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An 8-week-old baby boy presented at our institution with a continuous murmur and congestive heart failure. Echocardiography showed normal cardiac anatomy. Catheterization revealed the presence of a large thoracic arteriovenous fistula between the descending thoracic aorta and the hemiazygous system, with eventual drainage into the azygous vein and the innominate vein. Coil occlusion was performed successfully with a Gianturco coil.
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