A Case Report of Absent Right Superior Vena Cava with Persistent Left Superior Vena Cava: Echocardiographic Findings

Alhaj, Eyad; Pizzarello, Roy A.; Bergmann, Steven R.; Garcia, V; Trofimovsky, Paul

doi:10.1016/j.echo.2004.08.037

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…The echocardiogram can show enlarged coronary sinus draining into the right atrium, and a contrast echocardiography using agitated saline injected into the antecubital vein can show a specific finding of a contrast echo flowing into the right atrium from only the coronary sinus. 10,11 However, crosssectional imaging with computed tomography can help recognise the detailed anatomy and should be considered before an interventional procedure, if persistent left superior caval vein is suspected in the plain film or if there is a history of troubled endovascular procedure. With the ability to display a normal or abnormal course of the central veins on a single frame, multidetector computed tomography provides accurate anatomical information necessary for a successful catheterisation.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is difficult to diagnose an isolated persistent left superior caval vein with a simple X-ray film unless there is a central catheter or a pacemaker placed through the subclavian or internal jugular vein. The echocardiogram can show enlarged coronary sinus draining into the right atrium, and a contrast echocardiography using agitated saline injected into the antecubital vein can show a specific finding of a contrast echo flowing into the right atrium from only the coronary sinus 10 , 11 . However, cross-sectional imaging with computed tomography can help recognise the detailed anatomy and should be considered before an interventional procedure, if persistent left superior caval vein is suspected in the plain film or if there is a history of troubled endovascular procedure.…”

Section: Discussionmentioning

confidence: 99%

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Persistent left superior caval vein with absent right superior caval vein: importance of awareness

Lee

Han

2011

Cardiol Young

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Isolated persistent left superior caval vein is a rare anomaly of the systemic venous return. We describe an unsuccessful pacemaker implantation through the right subclavian vein, which later turned out to be due to a venous anomaly. This case and some other cases show that with the help of a multidetector computed tomography, an isolated persistent left superior caval vein is not a contraindication for subclavian approached pacemaker insertion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Persistent left superior caval vein with absent right superior caval vein: importance of awareness

Lee

Han

2011

Cardiol Young

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Real-Time Three-Dimensional Transesophageal Echocardiographic Imaging of Cor Triatriatum and Persistent Left Superior Vena Cava

Pericàs

Rodrı́guez-Fernández

Melis

et al. 2011

Journal of the American Society of Echocardiography

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Endovascular occlusion of right to left arteriovenous shunt associated with persistent left superior vena cava

Kougias

Peden

Lin

et al. 2006

Journal of Vascular Surgery

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Left-sided superior vena cava (SVC) as the result of persistence of the left superior cardinal vein in postnatal life is a rare congenital anomaly, is usually associated with other cardiac defects, and can cause symptoms of right to left shunt. We report the case of a 58-year-old Asian man with a history of end-stage renal disease and Ebstein anomaly that was corrected surgically who presented with progressively worsening disabling dyspnea. An echocardiogram with concomitant intravenous saline injection raised the suspicion of right to left shunt, a finding that was confirmed with contrast injection of the left SVC that rapidly filled the left heart chambers and subsequently the aortic arch. To treat this anomaly, we accessed the left basilic vein under ultrasound guidance and inserted a 14F sheath into the left subclavian vein. A covered stent was then prepared at the back table with three Prolene 4-0 sutures that were wrapped around the middle portion of the graft to achieve a controlled area of stenosis after deployment. The stent graft was placed along the proximal innominate vein and the contiguous part of the left SVC. Coil embolization was then performed with coils that were positioned at the stenotic area of the covered stent. An immediate venogram demonstrated residual flow into the left SVC; however, a delayed venogram 2 weeks after the procedure showed occlusion of the left SVC and the development of collaterals to the right innominate vein that was draining to a normal right SVC. The patient remained marginally hypotensive after surgery, but he soon noted a substantial improvement in his symptoms. A repeat echocardiogram with intravenous saline injection confirmed the correction of the right to left shunt. Endovascular repair of persistent left SVC is feasible and safe and can be performed with minimal morbidity.

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A Case Report of Absent Right Superior Vena Cava with Persistent Left Superior Vena Cava: Echocardiographic Findings

Cited by 3 publications

References 4 publications

Persistent left superior caval vein with absent right superior caval vein: importance of awareness

Persistent left superior caval vein with absent right superior caval vein: importance of awareness

Real-Time Three-Dimensional Transesophageal Echocardiographic Imaging of Cor Triatriatum and Persistent Left Superior Vena Cava

Endovascular occlusion of right to left arteriovenous shunt associated with persistent left superior vena cava

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