Persistent left superior vena cava identified by transesophageal echocardiography

Horvath, Sofia A.; Suraci, Nicholas; D'Mello, Jayanand; Santana, Orlando

doi:10.31083/j.rcm.2019.02.510

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…Some studies have concluded that transesophageal echocardiography (TEE) with agitated saline plays a significant role in diagnosis and can be the imaging tool of choice when evaluating PLSVC. 5,6 When PLSVCs are suspected with a dilated CS due to volume overload, 7 it is paramount that trained staff administer agitated saline via the left arm, and not the right, when the opportunity persists. In a PLSVC, bubbles will first appear in the CS before filling the right heart.…”

Section: Discussionmentioning

confidence: 99%

“…13 The hemodynamic implications of this anomaly are typically minimal; however, these incidental findings are important to forward to interventionists as their presence may make some procedures challenging to perform. 5,[14][15][16] One challenging intervention in the presence of a PLSVC is pacemaker implantation. 17 A case study by Totorean et al reports on an unknown PLSVC at the time of lead implantation, which deemed traditional transvenous implantation not feasible.…”

Section: Discussionmentioning

confidence: 99%

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Persistent Left Superior Vena Cava and Agitated Saline: A Strategically Thinking Sonographer’s Perspective

Trump,

Kallstrom

2024

Journal of Diagnostic Medical Sonography

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Comprehension of cardiac anatomy is critical for health care providers and allied health professionals in the pursuit of an accurate and timely patient diagnosis. Many times, when these anomalies are discovered, they are incidental findings from an asymptomatic patient during cardiovascular imaging. One specific anomaly which requires keen attention to detail and critical decision-making abilities is a persistent left superior vena cava (PLSVC). On a transthoracic echocardiogram (TTE), PLSVCs are discovered with the addition of agitated saline, commonly known as bubble studies. Because these anomalies are left-sided, it is critical for the sonographer and IV (intravenous)-trained staff to administer agitated saline through an IV on the left arm. Although rare, PLSVC may correlate with other cardiac pathologies, thus indicating the magnitude of a sonographer’s attention to surrounding anatomy (such as a dilated coronary sinus) and the necessity of appropriate IV location. This case study demonstrated the significance of a strategically thinking sonographer while diagnosing a PLSVC on TTE with agitated saline, which could have been missed if the IV line were not initiated on the left arm.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Persistent Left Superior Vena Cava and Agitated Saline: A Strategically Thinking Sonographer’s Perspective

Trump,

Kallstrom

2024

Journal of Diagnostic Medical Sonography

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“…PLSVC is caused by abnormal degeneration of the left anterior main vein, which starts in front of the left jugular vein and the left pulmonary artery, and in the lateral edge of the left atrium. It converges into the CS through the left atrioventricular sulcus, and finally enters the right atrium[ 10 ]. Based on the location of the flow into the heart, PLSVC is often divided into four types.…”

Section: Discussionmentioning

confidence: 99%

Accidental venous port placement via the persistent left superior vena cava: Two case reports

Zhou¹,

Ma²,

Wang³

et al. 2022

WJCC

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BACKGROUND Breast cancer poses a great threat to females worldwide. There are various therapies available to cure this common disease, such as surgery, chemotherapy, radiotherapy, and immunotherapy. Implantable venous access ports (IVAP, referred to as PORT) have been widely used for breast cancer chemotherapy. Venous malformations are possible conditions encountered during PORT implantation. Persistent left superior vena cava (PLSVC) is a common superior vena cava malformation. Most patients have normal right superior vena cava without affecting hemodynamics, so patients often have no obvious symptoms. CASE SUMMARY We incidentally found that two patients had PLSVC while a PORT was implanted via the internal jugular vein. Due to chemotherapy for breast cancer, PORT was successfully implanted under the guidance of ultrasound into these 2 patients. Positive chest X-ray examination after the operation showed that the catheter ran beside the left mediastinum and the end was located in the seventh thoracic vertebra. The patients had no catheter-related complications and successfully completed the course of chemotherapy. Ultrasonography found that the ratio of PORT outer diameter to PLSVC inner diameter was less than 0.45, which was in line with the recommendations of relevant literature and operating guidelines. The purpose of this article is to introduce two rare cases and review the relevant literature. CONCLUSION Correct assessment of PLSVC status and ultrasound-guided PORT placement generally does not affect breast cancer patients chemotherapy.

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“…The only limitation of thoracic contrast computed tomography is radiation exposure. MRI could be a best alternative significantly superior to both transthoracic and transesophageal echocardiography [ 9 , 10 ]. In our case, symptoms suggest the diagnosis of asthma.…”

Section: Discussionmentioning

confidence: 99%

Isolated Persistent Left Superior Vena Cava Revealed by an Associated Asthma

Bachouch

Belloumi

Attia

et al. 2021

Case Reports in Vascular Medicine

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Background. Persistent left superior vena cava (PLSVC) is a rare anomaly of the thoracic venous system. Case Report. We present a case of a patient with isolated asymptomatic PLSVC, who was diagnosed because of dyspnea revealing an associated asthma. An 18-year-old male patient complained of paroxystic sibilant dyspnea. He did not have any anomaly in physical examination. The chest X-ray revealed cardiomegaly with a widening of lower mediastinum. The electrocardiogram does not show any anomaly. Echocardiography showed the PLSVC. The thoracic contrast computed tomography of the chest showed ecstasies of the right cardiac cavities and a double superior vena cava. The patient did not have similar family cases. Respiratory functional explorations led to the diagnosis of an associated asthma. Currently, he is followed up periodically. Asthma was improved with inhaled corticosteroid treatment. Conclusion. PLSVC is rare but can have important clinical implications. Associated severe cardiac malformations must be systematically sought.

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Persistent left superior vena cava identified by transesophageal echocardiography

Cited by 6 publications

References 6 publications

Persistent Left Superior Vena Cava and Agitated Saline: A Strategically Thinking Sonographer’s Perspective

Persistent Left Superior Vena Cava and Agitated Saline: A Strategically Thinking Sonographer’s Perspective

Accidental venous port placement via the persistent left superior vena cava: Two case reports

Isolated Persistent Left Superior Vena Cava Revealed by an Associated Asthma

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