Isolated Persistent Left Superior Vena Cava, Role of Echocardiography Screening and CT angiography (original) (raw)
Related papers
Left persistent superior vena cava with large coronary sinus: A case report
Journal of Surgery and Medicine, 2018
Persistent left superior vena cava (LPSVC) is a rare and important congenital venous anomaly. It is caused by a defect in the closure of the left anterior cardinal vein during cardiac development. The LPSVC drains into the right atrium via the coronary sinus (CS) in 90% of cases, connects to the left atrium in 10 % of them. When cardiac anomalies are present, LPSVC is usually linked directly to left atrium. Thus, LPSVC which drains in the CS is generally isolated and asymptomatic. In our case, patient presented a heavy respiratory symptomatology without any diagnosis since all of the respiratory tests were normal. After realization of a computed tomography (CT), LPSVC had been discovered inducing a huge dilatation of CS, which its diameter was three times more than reported in literature and without any associated congenital heart disease. LPSVC seems to be a complex anatomic variation with different clinic and anatomic shapes. CS dilatation can be found in association with LPSVC in CT. As a result, it is important to use non-invasive cardiovascular examinations to make an optimal diagnosis of congenital cardiovascular variations and in order to avoid further interventional complications.
Introduction: A 71 year old asymptomatic woman came for an echocardiogram because of a left bundle branch block. A much dilated coronary sinus (CS) with an entering large vessel was found along with a mild left ventricular systolic dysfunction. Cardiac Magnetic Resonance (CMR) showed a persistent left superior vena cava (PLSVC), and an absent right superior vena cava (ARSVC). PLSVC drained into the dilated CS. No other cardiac abnormalities were found. Any late Gadolinium enhancement was also not seen. PLSVC and ARSVC are associated with sinus node and conduction tissue maldevelopment and atrial arrhythmias, and thus clinical follow up is indicated. Conclusion: CMR is a useful addition to echocardiogram to search for further cardiac abnormalities, and outline the anatomy with precision in doubtful cases. Key Words: Absent right superior vena cava, dilated coronary sinus, left bundle branch block, persistent left superior vena cava, systemic venous return abnormalities
Turkish Journal of Thoracic and Cardiovascular Surgery, 2014
Amaç: Bu çalışmada koroner sinüsü geniş olan hastalarda büyük torasik venlerin dönüş anormalliklerini saptayabilmede ekokardiyografinin rolü araştırıldı. Ça lış mapla nı:Ocak 2010 -Şubat 2012 tarihleri arasında kliniğimizde altı hastaya (3 erkek, 3 kız; ort. yaş 4.1; dağılım 3 gün -9 yıl) kalıcı sol superior vena kavanın (SVK) eşlik ettiği sağ superior vena kava (SVK) yokluğu tanısı konuldu. Sağ SVC yokluğu tanısı ekokardiyografi ve anjiyografi ile konuldu. Bul gu lar: Dört hastada sağ SVK yokluğu tanısı ekokardiyografi ile teyit edildi. İki hastada ise, kardiyak kateterizasyon ve anjiyografi ile tanı konuldu. Ek kardiyak anomaliler periferik pulmoner darlık, patent duktus arteriyozus, Fallot tetralojisi, atriyal septal defekt, ventriküler septal defekt ve kesintili aortik ark tip B idi. Bir hasta Trizomi 9p sendromlu iken, diğeri diyabetik bir annenin bebeği idi. Üç hasta klinik izleme alındı, diğer üç hasta ameliyat edildi. So nuç:Ekokardiyografi ile ortaya konduğu üzere, koroner sinüsün geniş olduğu, koroner sinüs akımının arttığı ve kalıcı sol SVK'nin görüldüğü olgularda sağ SVK yokluğunun dikkatli bir şekilde araştırılması gerekmektedir.
A case of absent right and persistent left superior vena cava
Cardiovascular ultrasound, 2006
Our case report deals with the importance of detailed echocardiographic examination for differential diagnosis of coronary sinus dilation and development of abnormalities of great thoracic veins. A 49-year-old man underwent transthoracic echocardiography for atypical chest pain. A dilated coronary sinus was found and venous contrast echocardiography raised the suspicion of absent right and persistent left superior vena cava. Transesophageal echocardiography showed absence of right superior vena cava. The echocardiographic findings were confirmed by upper venous digital subtraction cavography. combination of agenesia of right SVC and isolated persistent left SVC in adult patients is a very rare abnormality. Both clinicians and sonographers should be alerted to the possible presence of this combined venous anomaly. Transthoracic echocardiograpy - including agitated saline infusion to the antecubital vein - is an important diagnostic tool for accurate diagnosis of this congenital thora...
Persistence of left superior vena cava, absence of coronary sinus and cerebral ictus
International Journal of Cardiology, 2008
Persistence of left superior vena cava (LSVC) is the most frequent venous thoracic congenital anomaly. Right superior vena cava (RSVC) develops, during embryogenesis, from right anterior cardinal vein, while left anterior cardinal vein atrophies . If left anterior cardinal vein persists during embryogenesis, persistence of LSVC occurs. This anomaly occurs in 0.3-0.5% of the normal population and in 1.3-10% of patients with cardiac malformations including anomalus drainage of left pulmonary veins, hypoplasia of left-sided structures (e.g. mitral stenosis or coarction), and other complex congenital heart disease [2,3]. RSVC is absent in 1% of patients with persistence of LSVC . Communication between LSVC and RSVC may be present through innominate vein. Absence of coronary sinus is a rare eventuality in persistence of LSVC , usually associated with interatrial defect . Persistence of LSVC usually drains into right atrium throw coronary sinus (92%) or directly into left atrium (8%, unroofed coronary sinus). The latter may lead to left-to-right shunt and cyanosis or to paradox embolism . Isolated persistent LSVC is usually not recognized until left cephalic or subclavian approach is used for diagnostic and therapeutic transcatheter procedures. Coronary sinus drainage assumes importance in case of central venous catheters or transvenous pacing lead placement, or during cardiovascular surgery (absolute contraindication in retrograde cardioplegia) [6].
Persistent left superior vena cava diagnosed by contrast transesophageal echocardiography
American Heart Journal, 1991
e Abstract-Background: Persistent left superior vena cava (PLSVC) is a congenital anomaly with an estimated incidence of 0.3-0.5% in the normal population. Its usual discovery is often made by an abnormally positioned catheter inserted in the left subclavian or left jugular vein. In this situation, an easy bedside approach to confirm an anatomic variation in the central venous system is helpful. In the majority of cases, the PLSVC drains to the coronary sinus. Objective: To describe the contribution of bedside echocardiography in diagnosing the unstable patient in whom there is suspicion of a PLSVC. Case Report: A 29-year-old man underwent an emergent laparotomy for multiple intra-abdominal abscesses. Postoperatively, after insertion of a central line catheter through the left subclavian vein, a chest X-ray study showed the tip of the catheter in a left paramediastinal position instead of crossing the midline to the superior vena cava. A PLSVC was suspected. The patient was hemodynamically unstable; therefore, a bedside non-invasive confirmation of the diagnosis of PLSVC was preferred. A transthoracic echocardiography study was performed after injection of agitated saline (creating air-filled microbubbles by shaking saline solution in a syringe), which showed that the coronary sinus was opacified, confirming the diagnosis of a PLSVC. Conclusion: In this brief report, we describe the contribution of echocardiography to the diagnosis of a PLSVC. Echocardiography is a reliable and easy diagnostic tool that allows a bedside approach in a patient in whom there is suspicion of a PLSVC, without administration of radiographic contrast. © 2010 Elsevier Inc. e Keywords-persistent left superior vena cava; echocardiography; bedside approach; abnormal positioned central venous catheter; agitated saline test 640 J. Walpot et al.
Persistent Left Superior Vena Cava Draining into the Coronary Sinus: A Case Report
Cardiology research, 2011
Persistent left superior vena cava (PLSVC) is a congenital anomaly of the thoracic venous system resulting from the abnormal persistence of an embryological vessel that normally regresses during early fetal life. This anomaly is often discovered incidentally during surgery, cardiovascular imaging or invasive cardiovascular procedures. In most cases, a PLSVC drains into the right atrium through the coronary sinus. In the remainder of cases, it enters directly or through the pulmonary veins into the left atrium. A dilated coronary sinus on echocardiography should always raise the suspicion of a PLSVC as it has important clinical implications. The diagnosis should be confi rmed by saline contrast echocardiography. We report a patient with persistent left superior vena cava with an enlarged coronary sinus and normal right superior vena cava.
2021
An unroofed coronary sinus is a rare congenital anomaly in the roof of the coronary sinus causing a communication between the coronary sinus and the left atrium leading to a left to right shunt. It is often associated with a persistent left superior vena cava and other complex congenital lesions like anomalous pulmonary venous return and heterotaxy. Since it is a deep-seated defect, it is seldom diagnosed by transthoracic two-dimensional (2D) echocardiography and requires multimodal imaging for a diagnosis. Here, we present the case of a 27-year-old male in whom the defect was very apparent on standard 2D transthoracic echocardiography. Transthoracic 2D echocardiography revealed situs solitus, levocardia, and a dilated coronary sinus with unroofing which was most prominent in the standard parasternal long-axis view and the foreshortened apical four-chamber view. A color Doppler demonstrated a flow from the left atrium into the dilated coronary sinus. The right ventricle and atrium w...