Atresia of the right atrial ostium of the coronary sinus unassociated with persistence of the left superior vena cava: A clinicopathologic study of four adult patients

Persistent left superior vena cava (PLSVC) is the most common variant of abnormal venous return to the heart. While usually asymptomatic, it is known to complicate transvenous cardiac procedures, such as implantation of cardiac electronic devices and ablations. PLSVC can present with or without the concomitant absence of right superior vena cava (RSVC). Depending on the operator's preference, implantation of permanent cardiac pacemakers (PPMs) may be performed from the left or right side. As most often the PLSVC is only identified at the time of intervention, it follows that the variant with the absence of RSVC can be diagnosed in practice only when implanting from the right side. For this reason, the true prevalence of this variant is largely unknown because most published cases of cardiac device implantations in patients with PLSVC have been performed from the left side. We present a short 3-case series of PPM implantations in a tertiary center from the right side in patients with PLSVC and absent RSVC. We found that the use of a standard curve for ventricular lead septal placement and a wide C-curve for right atrial lead placement in these patients was a feasible technique with good outcomes.

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Giant coronary sinus and absent right superior vena cava

VASA ◽

10.1024/0301-1526/a000071 ◽

2011 ◽

Vol 40 (1) ◽

pp. 65-67 ◽

Cited By ~ 7

Author(s):

Yuce ◽

Kizilkan ◽

Kus ◽

Davutoglu ◽

Sari

Keyword(s):

Superior Vena Cava ◽

Coronary Sinus ◽

Superior Vena ◽

Pacemaker Implantation ◽

Vena Cava ◽

Disease Diagnosis ◽

Left Superior Vena Cava ◽

Venous Catheterization ◽

Heart Disease Diagnosis ◽

The Right

Although persistent left superior vena cava (PLSVC) is rare, it is the most common thoracic venous anomaly. The prevalence of PLSVC is 0.3 % in a general population and 10 % in patients with congenital heart disease. Diagnosis of PLSVC is usually incidental during cardiovascular imaging or surgery. Although PLSVC is usually not associated with any negative hemodynamic effect, it is important to be aware of its existence, since it may cause problems in central venous catheterization, pacemaker implantation and cardiopulmonary bypass. The overall proportion of absent right superior vena cava in patients with PLSVC is approximately 20 %. If PLSVC is associated with absence of the right superior vena cava, the coronary sinus may become gigantic due to excessive inflow. Herein, we report a case of PLSVC complicated by the absence of a right superior vena cava resulting in a giant coronary sinus.

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Dilated Coronary Sinus: An Indicator of Persistent Left Superior Vena Cava

Asploro Journal of Biomedical and Clinical Case Reports ◽

10.36502/2020/asjbccr.6197 ◽

2020 ◽

Vol 3 (2) ◽

pp. 116-117

Author(s):

Otero D ◽

Stoddard M ◽

Ikram S

Keyword(s):

Superior Vena Cava ◽

Coronary Sinus ◽

Jugular Vein ◽

Superior Vena ◽

Vena Cava ◽

Left Superior Vena Cava ◽

Flow Through ◽

The Right ◽

Dilated Coronary Sinus ◽

Axis View

An 88-year-old male presented for a routine transthoracic echocardiogram. Dilated coronary sinus was noted, raising the suspicion for persistent left superior venous cava (PLSVC). An agitated saline study from the left upper extremity demonstrated a flow through the coronary sinus into the right ventricle in a parasternal long-axis view. A venogram from the right internal jugular vein showed the PLSVC drained into a much dilated coronary sinus (CS) that connected to the right atrium. The right superior vena cava was absent. PLSVC along with absent right superior vena cava is rare and the inadvertent CS cannulation may result in vessel perforation.

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PERSISTENT LEFT SUPERIOR VENA CAVA: A DECEPTIVE ANOMALY

Journal of Cancer & Allied Specialties ◽

10.37029/jcas.v5i1.207 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Javaria Aleem ◽

Waqas Ahmad

Keyword(s):

Superior Vena Cava ◽

Coronary Sinus ◽

Superior Vena ◽

Pulmonary Veins ◽

Vena Cava ◽

Central Venous Line ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

Vena Cava Superior ◽

The Right

Persistent left superior vena cava (SVC) is a rare but vital congenital anomaly of the thoracic venous system. It is the persistence of vessel that normally regresses during early foetal life. It has utmost importance in intervention radiology, cardiothoracic procedures and insertion of the central venous line as well as in trauma. The vessel can drain into the right atrium through the coronary sinus, directly into left atrium or through pulmonary veins. It is usually detected during routine investigations and requires surgical treatment. In our case, SVC persists on both right and left sides with enlarged coronary sinus incidentally detected during follow-up for breast cancer.Key words: Persistent left superior vena cava, superior vena cava, vascular variant

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Successful placement of a deflectable decapolar catheter via the right femoral vein approach in a patient with coronary sinus ostial atresia and persistent left superior vena cava

Heart Asia ◽

10.1136/heartasia-2014-010563 ◽

2014 ◽

Vol 6 (1) ◽

pp. 128-129 ◽

Cited By ~ 1

Author(s):

C. T. Ng ◽

J. See ◽

C. W. Lee ◽

C.-K. Ching

Keyword(s):

Superior Vena Cava ◽

Coronary Sinus ◽

Superior Vena ◽

Femoral Vein ◽

Vena Cava ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

The Right

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Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review

Diagnostics ◽

10.3390/diagnostics10121071 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1071

Author(s):

Mihai Cristian Haba ◽

Andreea Maria Ursaru ◽

Antoniu Octavian Petriș ◽

Ștefan Eduard Popescu ◽

Nicolae Dan Tesloianu

Keyword(s):

Superior Vena Cava ◽

Coronary Sinus ◽

Superior Vena ◽

Vena Cava ◽

Right Atrial ◽

Left Ventricular Ejection ◽

Dual Chamber ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

Cardioverter Defibrillator

Persistence of the left superior vena cava (PLSVC) is a congenital anomaly reported in 0.3–0.5% of patients. Due to the multiple and complex anatomical variations, transvenous lead placement can become challenging. We report the case of a 47-year-old patient diagnosed with non-ischemic dilated cardiomyopathy with reduced left ventricular ejection fraction (LVEF—27%), who was referred to our clinic for implantation of a dual-chamber cardioverter defibrillator for primary prevention of sudden cardiac death. During the procedure we encountered an abnormal guidewire trajectory and after venographic examination we established the diagnosis of persistent left superior vena cava. After difficult implantation of a 7F defibrillation lead through the coronary sinus, we managed to place the atrial lead through a narrow brachiocephalic vein into the right atrial appendage. In this paper, we aim to illustrate the medical and technical implications of implanting a cardioverter defibrillator in patients with PLSVC, highlighting the benefit of identifying and utilizing both the innominate vein, and the left superior vena cava and coronary sinus for placement of multiple leads, which would otherwise have been impossible.

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