Percutaneous Intervention of a Persistent Left Superior Vena Cava Draining Into Left Pulmonary Vein and Coarctation of the Aorta

Bugami, Saad Al; Althobaiti, Mohammed; Momenah, Tarek; AlRahimi, Jamilah; Kashkari, Wael Al

doi:10.14740/cr477w

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…As with the general expert consensus that led to prior guidelines for comparable shunt lesions such as unroofed coronary sinus ( 8 ), closure of an LSVC with a left-sided heart connection is reasonable: significant hemodynamic shunt (pulmonary-to-systemic flow ratio >1.5), exertional hypoxia, or embolic events. The transcatheter closure technique of the LSVC with the use of vascular plug is similar to what is described in published reports ( 7 , 9 ). However, the more proximal location of the LSVC and LUPV confluence in this patient did require careful deployment of the plug, to avoid jeopardizing LUPV drainage.…”

Section: Discussionmentioning

confidence: 76%

Transcatheter Closure of Persistent Left Superior Vena Cava Draining to Pulmonary Vein

et al. 2020

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Section: Discussionmentioning

confidence: 76%

Transcatheter Closure of Persistent Left Superior Vena Cava Draining to Pulmonary Vein

et al. 2020

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“…The unique anatomic variant in our patient was amenable to re-routing and preservation of LSVC return to the RA by transcatheter placement of a covered stent; without sacrificing the systemic venous pathway by device occlusion of the LSVC in previous reports. 4 , 7 , 8 , 10 , 12 This strategy also avoids the risks of a re-do sternotomy, cardiopulmonary bypass, and attendant surgical morbidities. This concept is similar to the recently reported covered stent correction of sinus venosus atrial septal defect with encouraging early outcomes.…”

Section: Discussionmentioning

confidence: 99%

Case report of a left superior vena cava to left atrial connection treated with percutaneous covered stent placement

Duong

Papaioannou

Moharam-Elgamal

et al. 2022

European Heart Journal - Case Reports

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Background Persistent left superior vena cava (LSVC) with connection to the left atrium (LA) is a rare anomaly with serious clinical implications. Depending on the direction of flow through the intracardiac shunt, clinical presentation varies from cyanosis or paradoxical embolism to overt right heart failure. Case Summary A 26-year-old man with repaired ventricular septal defect (VSD) during infancy presented with symptoms of progressive exercise intolerance. Cardiac imaging revealed a large defect at the posterior wall of the LSVC above its entry to the coronary sinus (CS), connecting the LSVC with the left atrium and resulting in diversion of pulmonary venous return to the CS. All pulmonary veins connect normally to the left atrium. The large left to right intracardiac shunt led to significant right ventricular dilation and tricuspid regurgitation. He underwent successful anatomical repair with transcatheter implantation of covered stent from LSVC to the CS, redirecting pulmonary venous return to the LA. At 10 month follow up, his exercise capacity had improved, and cardiac imaging showed complete seal of the LSVC defect without obstruction to pulmonary venous return. Discussion Our case is the first to our knowledge to report this unusual anatomic variant of LSVC to LA connection, and complete repair by transcatheter treatment. Previous case reports of other forms of LSVC to LA connection were treated with surgery or device occlusion without reconnection of LSVC. This case highlights the efficacy and safety of innovative percutaneous techniques in the management of complex congenital heart lesions. Meticulous procedural planning through 3D modeling and simulation is vital to mitigate the risks of these innovative procedures.

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“…Although these are usually without significant clinical implications, awareness of these anomalies is necessary to avoid diagnostic pitfalls and is an essential pre-operatively or pre-transcatheter intervention [4]. Few studies suggested a correlation between venae cavae anomalies and CoA, such as persistent left-sided SVC and CoA [5]. There is a reported case of interrupted left-sided IVC with hemiazygous continuation to persistent left-sided SVC in a patient with CoA [6].…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Intervention For Severe Aortic Coarctation in a Patient With Uninterrupted Left-Sided Inferior Vena Cava Presenting With Recurrent Abdominal Pain

Alkashkari

Al-Husayni

Althobaiti

et al. 2020

Cureus

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We describe a case of a 17-year-old male patient who was admitted to the hospital for an evaluation of his recurrent postprandial abdominal pain and fatigue on exertion. He was discovered to have severe post-ductal aortic coarctation (CoA) and uninterrupted left-sided inferior vena cava (IVC) draining into the right atrium crossing anterior to the abdominal aorta. There were no signs of IVC compression. Patient symptoms improved dramatically after CoA stenting on follow up. The presence of uninterrupted left-sided IVC in this particular case created a diagnostic dilemma, and it was of great importance to know such anomaly before the procedure. This association of uninterrupted left-sided IVC with CoA is unusual, and to our knowledge, our case is the first to report such congenital association.

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Percutaneous Intervention of a Persistent Left Superior Vena Cava Draining Into Left Pulmonary Vein and Coarctation of the Aorta

Cited by 3 publications

References 20 publications

Transcatheter Closure of Persistent Left Superior Vena Cava Draining to Pulmonary Vein

Transcatheter Closure of Persistent Left Superior Vena Cava Draining to Pulmonary Vein

Case report of a left superior vena cava to left atrial connection treated with percutaneous covered stent placement

Transcatheter Intervention For Severe Aortic Coarctation in a Patient With Uninterrupted Left-Sided Inferior Vena Cava Presenting With Recurrent Abdominal Pain

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