Persistent left hepatic venous connection with the right atrium and the ductus venosus

Azuma, Cho; Tohno, Yoshiyuki; Tohno, Setsuko; Moriwake, Yumi; Utsumi, Masako; Yamada, Masa-oki

doi:10.1046/j.0022-7722.2002.00001.x

Cited by 13 publications

(20 citation statements)

References 9 publications

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“…2,5,6,10 The occurrence of left hepatic vein drainage into the right atrium may be explained due to the persistence of the left vitelline connection with the left sinus horn, 14,15 as was the case in our patient. This is an extremely rare finding that has been reported only once in association with PLSVC 16 and in another report as an isolated autopsy finding. 15 …”

Section: Embryologymentioning

confidence: 88%

Persistent left superior vena cava (PLSVC) with anomalous left hepatic vein drainage into the right atrium: role of imaging and clinical relevance

et al. 2007

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An 86-year-old white male with a history of inferior wall myocardial infarction 25 years ago, chronic atrial fibrillation and hyperlipidemia presented with shortness of breath, dizziness of several weeks' duration, and chronic stable angina. Physical exam was remarkable for bradycardia with regular rhythm and normal S1 and S2 with a systolic ejection murmur. ECG on admission showed complete heart block with a ventricular rate of 37 beats/min. Cardiac biomarkers were negative. His heart rate then decreased to 29 beats/min and atropine 0.5 mg followed by 1 mg was given without any response.During pacemaker implantation a fluoroscopic examination of the thoracic anatomy demonstrated normal structure. Initially, the left subclavian vein approach was employed. Multiple attempts to locate the left subclavian vein percutaneously in the usual infra-clavicular fashion under fluoroscopic guidance were not successful. Therefore, a left brachial venogram was performed using 15 cc of nonionic contrast injected into the left antecubital vein. The cineangiogram demonstrated patency of the subclavian vein but with very slow flow and a suggestion of a vertical course of the subclavian vein along the left mediastinum. The left brachial vein was accessed using a micropuncture needle and a flexible guide wire was advanced which confirmed the suspicion of a persistence of left superior vena cava (Figure 1). Therefore, the left subclavian vein approach for the pacing lead insertion was abandoned. Next, under fluoroscopic guidance, the right subclavian vein was accessed with the micropuncture needle followed by placement of a guide wire into the right atrium without difficulty.Echocardiography showed markedly dilated left and right atria (8.9 ϫ 8.1 cm, 9.3 ϫ 8.5 cm, respectively) with an intact interatrial septum. An enlarged coronary sinus draining into the right atrium was observed. Abstract: Persistent left superior vena cava (PLSVC) is a very rare and yet the most commonly described thoracic venous anomaly in medical literature. It has a 10-fold higher incidence with congenital heart disease. PLSVC often becomes apparent when an unknown PLSVC is incidentally discovered during central venous line placement, intracardiac electrode/pacemaker placement or cardiopulmonary bypass, where it may cause technical difficulties and life-threatening complications. PLSVC is also associated with disturbances of cardiac impulse formation and conduction including varying degrees of heart blocks, supraventricular arrhythmias and Wolff Parkinson White syndrome. We describe the case of an 86-year-old male with a history of coronary artery disease and chronic atrial fibrillation who presented with worsening dyspnea and syncopal episodes. An ECG was consistent with complete heart block. During lead placement for the pacemaker, a left subclavian approach was unsuccessful. A left venogram was performed through the brachial vein that demonstrated a left superior vena cava. The diagnosis was confirmed with echocardiography using a bubble study and also a c...

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Section: Embryologymentioning

confidence: 88%

Persistent left superior vena cava (PLSVC) with anomalous left hepatic vein drainage into the right atrium: role of imaging and clinical relevance

et al. 2007

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“…Previous studies reported that the accessory foramina of the VHs on the diaphragm could be on either side of the CO. 3,7,8 In the present study, we found them on the right side of the CO in all Type 1 cases (posterior to, at the same level with and anterior to the CO in 6, 2 and 1 case, respectively). One of the FVH in Types 2 and 3…”

Section: Variations Of Hepatic Veins Opening Into the Inferior Vena Cavamentioning

confidence: 67%

Review of 13 fetal cases with hepatic veins opening variously into the inferior vena cava within the diaphragm

Evcil¹

2009

Anatomy

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Venous blood of the liver drains to the inferior vena cava (IVC) via the hepatic veins (HVs).1 Usually a total of three HVs leave the liver though numerical variations is not uncommon. AbstractObjectives: We aimed to investigate the 13 fetal cases with hepatic veins opening variously into the inferior vena cava within the diaphragm. Methods:The study was carried out on 13 human fetuses (seven males and six females) aged between 21-40 weeks of gestation. The diaphragm, foramina on the diaphragm, inferior vena cava and the hepatic veins were exposed by thoracoabdominal dissections. In 13 fetal materials, variations in the foramina of the hepatic veins into the inferior vena cava on the undersurface of the diaphragm were observed. Results:In 13 fetal materials, the hepatic veins did not directly open into the inferior vena cava but formed accessory foramen/foramina on the undersurface of the diaphragm and joined the inferior vena cava within the diaphragm. Accompanying the caval opening, there were 1-3 accessory foramina on the inferior but not superior surface of the diaphragm in 13 cases.A single hepatic vein in nine cases, two hepatic veins in two cases and three hepatic veins in two cases were found to open into the inferior vena cava within the diaphragm.Conclusion: Physicians and researchers should be aware of the fact that during the fetal period, hepatic veins can open into the inferior vena cava with different ways within the diaphragm. These variations need to be taken into consideration in evaluating the caval opening on the diaphragm during obstetric ultrasonography and surgical interventions in the prenatal period.

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“…In general, three main hepatic veins drain the liver into the inferior vena cava below the diaphragm, 12 and a single hepatic vein draining directly to the right atrium is occasionally reported. 13,14 However, it is rare to see the three main hepatic veins draining directly to the right atrium. A search of PubMed using the keywords, right atrium and hepatic vein, did not find any reports of this anomaly.…”

Section: Discussionmentioning

confidence: 98%

Hepatic Resection for Metastatic Colon Cancer in Patients with Situs Inversus Totalis Complicated by Multiple Anomalies of the Hepatobiliary System: The First Case Report

Uemura

Maeda

Munekage

et al. 2009

Journal of Gastrointestinal Surgery

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Persistent left hepatic venous connection with the right atrium and the ductus venosus

Cited by 13 publications

References 9 publications

Persistent left superior vena cava (PLSVC) with anomalous left hepatic vein drainage into the right atrium: role of imaging and clinical relevance

Persistent left superior vena cava (PLSVC) with anomalous left hepatic vein drainage into the right atrium: role of imaging and clinical relevance

Review of 13 fetal cases with hepatic veins opening variously into the inferior vena cava within the diaphragm

Hepatic Resection for Metastatic Colon Cancer in Patients with Situs Inversus Totalis Complicated by Multiple Anomalies of the Hepatobiliary System: The First Case Report

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