Gradual diagnosis and clinical importance of prenatally detected persistent left superior vena cava with absent right superior vena cava – a case report and literature review

Abstract

Persistent left superior vena cava is a malformation of cardinal veins. We report a case of a secundigravida who had many fetal ultrasound examinations – first performed by an obstetrician (who described fetal mediastinum as “abnormal”), second by other obstetrician, who performed basic fetal echocardiographic examination and diagnosed persistent left superior vena cava. The woman was referred to a tertiary center for detailed fetal echocardiography. The diagnosis of persistent left superior vena cava with agenesis of the right superior vena cava was confirmed. The anomaly had no influence on fetal hemodynamic stability, fetal life, delivery and early postnatal period. After delivery, the neonate was under observation for further anomalies, aortic coarctation in particular. Prenatal and postnatal management was summarized. Literature review is presented.

Single left superior vena cava: antenatal diagnosis, associated anomalies and outcomes

“…When BSVC is strictly isolated, a genetic anomaly is usually absent. Conversely, single LSVC is usually an isolated antenatal finding 7–10,12 , as seen in this series. Genetic abnormalities are rarely reported in single LSVC 11 , and such an abnormality was seen in only one case in our series.…”

“…Conversely, single LSVC is usually an isolated antenatal finding [7][8][9][10]12 as seen in this series.…”

Persistent Left Superior Vena Cava Associated with Right Aberrant Subclavian Artery Detected during Totally Implantable Vascular Access Device Insertion

“… 7 Its prevalence does not differ significantly between males and females. 7 The prevalence may be higher if PLSVC was not associated with abnormalities such as hypoplastic thymus and esophageal atresia, 8 which can lead to spontaneous abortions and premature births. 7 There is an increase in associated chromosomal anomalies, the most common association being trisomy 18.…”

“… 7 There is an increase in associated chromosomal anomalies, the most common association being trisomy 18. 8 …”

“…7 There is an increase in associated chromosomal anomalies, the most common association being trisomy 18. 8 John Marshall first reported PLSVC in 1850, 1 and since then, various hypotheses about its development have been suggested. 7 Normally, during the eighth week of embryologic development, a substantial venous anastomosis forms between the left and right precardinal veins, 5 then increased blood flow to the right precardinal vein occurs, allowing it to enlarge.…”