Persistent Left Superior Vena Cava: A Rare Association

Persistent left superior vena cava is the most common congenital anomaly of thoracic venous return, which results when the left anterior cardinal vein fails to regress. A 41-year-old African American male with a history of an unspecified childhood cardiac murmur presented to the emergency department with congestive heart failure exacerbation revealing an incidental finding of a persistent left superior vena cava. Ultimately, he required implantable cardioverter defibrillator placement and cardiac transplantation assessment. In the setting of advanced device placement or cardiac transplantation, a persistent left superior vena cava warrants several important clinical considerations at a center capable of addressing the possibility of a right-sided approach and transplantation irregularities.

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Knowledge of the Anomalies of the Big Central Veins Reduces the Morbidity during the Cannulation for Hemodialysis: Description of a Case of Persistent Left Superior Vena Cava and Revision of Literature

The Journal of Vascular Access ◽

10.1177/112972980300400106 ◽

2003 ◽

Vol 4 (1) ◽

pp. 25-31 ◽

Cited By ~ 1

Author(s):

P. Dionisio ◽

C. Borsetti ◽

M. Valenti ◽

E. Caramello ◽

R. Bergia ◽

...

Keyword(s):

Central Venous Catheter ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Venous Catheter ◽

Central Venous ◽

Left Superior Vena Cava ◽

Cardinal Vein ◽

Persistent Left Superior Vena ◽

Congenital Agenesis

The persistence of a left superior vena cava is the result of a lack of an embryological involution of the left anterior cardinal vein. This anomaly is very rare: about 0.3% of the general population. Its incidence increases remarkably from 3–10% in those patients affected with congenital heart disease. Described herein is a case of persistent left superior vena cava, discovered by chance, following the placement of a central venous catheter for hemodialysis. A chest X-ray in projection back-forward showed the central venous catheter along the left sternal margin simulating a placement in the aorta artery. This clinical picture, as described in the literature, is often accompanied by other anatomical anomalies, in our case, by the congenital agenesis of a solitary pelvic kidney. In agreement with the literature and in contrast with what has been reported recently, we sustain that a central venous catheter placed, for any reason, in the persistent left superior vena cava must be removed immediately because it can induce hyperkinetic arrhythmia and cardiac arrest as in our case. Our case report should be a warning that lack of awareness of the anomalies of the big central veins can cause a rise in morbidity.

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Persistent Left Superior Vena Cava: What the Interventional Nephrologist Needs to Know

The Journal of Vascular Access ◽

10.1177/112972980901000313 ◽

2009 ◽

Vol 10 (3) ◽

pp. 207-211 ◽

Cited By ~ 28

Author(s):

Antonio Granata ◽

Simeone Andrulli ◽

Fulvio Fiorini ◽

Francesco Logias ◽

Michele Figuera ◽

...

Keyword(s):

Superior Vena Cava ◽

Central Venous Catheterization ◽

Jugular Vein ◽

Superior Vena ◽

Vena Cava ◽

Embryological Development ◽

Left Superior Vena Cava ◽

Cardinal Vein ◽

Persistent Left Superior Vena ◽

Venous Catheterization

Variations in the course of the blood vessels are often incidental findings during clinical examination. Persistent left superior vena cava (PLSVC) is an uncommon anomaly, estimated to be present in about 0.3–0.5% of healthy individuals and in about 3–10% of patients with congenital heart disease. It results from the failure of the left anterior cardinal vein to degenerate during embryological development. Serious complications such as shock, angina and cardiac arrest have been described during catheterization in adults with a PLSVC. Since it frequently goes undiagnosed because of lack of symptoms when not accompanied by other anomalies, variations of the superior vena cava should be considered, especially when central venous catheterization via the subclavian or internal jugular vein is difficult. The embryological development, diagnosis, and clinical implications of a PLSVC are therefore reviewed in this article.

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Knowledge of the Anomalies of the Big Central Veins Reduces the Morbidity during the Cannulation for Hemodialysis: Description of a Case of Persistent Left Superior Vena Cava and Revision of Literature

The Journal of Vascular Access ◽

10.5301/jva.2008.3680 ◽

2003 ◽

Vol 4 (1) ◽

pp. 25-31 ◽

Cited By ~ 3

Author(s):

P. Dionisio ◽

C. Borsetti ◽

M. Valenti ◽

E. Caramello ◽

R. Bergia ◽

...

Keyword(s):

Central Venous Catheter ◽

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Venous Catheter ◽

Central Venous ◽

Left Superior Vena Cava ◽

Cardinal Vein ◽

Persistent Left Superior Vena ◽

Congenital Agenesis

The persistence of a left superior vena cava is the result of a lack of an embryological involution of the left anterior cardinal vein. This anomaly is very rare: about 0.3% of the general population. Its incidence increases remarkably from 3–10% in those patients affected with congenital heart disease. Described herein is a case of persistent left superior vena cava, discovered by chance, following the placement of a central venous catheter for hemodialysis. A chest X-ray in projection back-forward showed the central venous catheter along the left sternal margin simulating a placement in the aorta artery. This clinical picture, as described in the literature, is often accompanied by other anatomical anomalies, in our case, by the congenital agenesis of a solitary pelvic kidney. In agreement with the literature and in contrast with what has been reported recently, we sustain that a central venous catheter placed, for any reason, in the persistent left superior vena cava must be removed immediately because it can induce hyperkinetic arrhythmia and cardiac arrest as in our case. Our case report should be a warning that lack of awareness of the anomalies of the big central veins can cause a rise in morbidity.

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Persistent Left Superior Vena Cava and Partial Anomalous Pulmonary Venous Return in an Old Asymptomatic Female Patient

Cardiology Research and Practice ◽

10.4061/2009/152164 ◽

2009 ◽

Vol 2009 ◽

pp. 1-2 ◽

Cited By ~ 5

Author(s):

Tayfun Sahin ◽

Teoman Kilic ◽

Umut Celikyurt ◽

Ulas Bildirici ◽

Dilek Ural

Keyword(s):

Superior Vena Cava ◽

Coronary Sinus ◽

Cardiac Development ◽

Superior Vena ◽

Vena Cava ◽

Left Superior Vena Cava ◽

Cardinal Vein ◽

Persistent Left Superior Vena ◽

Septal Defects ◽

Dilated Coronary Sinus

Persistent left superior vena cava is a rare congenital venous anomaly. It results from failure of closure of the left anterior cardinal vein during cardiac development. It is usually asymptomatic but can be associated with other congenital cardiac defects including atrial septal defects, ventricular septal defects, endocardial cushion defects, tetralogy of Fallot and rhythm disturbances. PLSVC should be considered in the presence of a dilated coronary sinus on transthoracic echocardiography. The diagnosis can be made when injection of contrast in left antecubital vein results in enhancement of the dilated coronary sinus before right atrium. MRI, CT-scan and catheterisation can be used to confirm the diagnosis.

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A rare association recognized before cardiac surgery: Persistent left superior vena cava and secundum atrial septal defect

International Journal of Cardiology ◽

10.1016/j.ijcard.2007.08.028 ◽

2009 ◽

Vol 132 (2) ◽

pp. e82-e84 ◽

Cited By ~ 3

Author(s):

Mutlu Buyuklu ◽

Osman Ufacik ◽

Osman Pirhan ◽

Ersan Tatli

Keyword(s):

Cardiac Surgery ◽

Atrial Septal Defect ◽

Superior Vena Cava ◽

Septal Defect ◽

Superior Vena ◽

Vena Cava ◽

Secundum Atrial Septal Defect ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

Rare Association

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Persistent Left Superior Vena Cava Associated with Hemiazygos Vein Draining in It and Absence of Left Brachiocephalic Vein, in a Patient with Congenital Heart Defect

Journal of Interdisciplinary Medicine ◽

10.1515/jim-2016-0041 ◽

2016 ◽

Vol 1 (2) ◽

pp. 201-205

Author(s):

Diana Opincariu ◽

Alexandra Stănescu ◽

Alina Corduneanu ◽

Laura Jáni ◽

András Mester ◽

...

Keyword(s):

Superior Vena Cava ◽

Superior Vena ◽

Pacemaker Implantation ◽

Vena Cava ◽

Brachiocephalic Vein ◽

Left Superior Vena Cava ◽

Cardinal Vein ◽

Persistent Left Superior Vena ◽

Left Brachiocephalic Vein ◽

Hemiazygos Vein

Abstract Persistent left superior vena cava is an anomalous vein that derives from a malfunction of obliteration of the left common cardinal vein during intrauterine life. The diagnosis can be suggested by a dilated coronary sinus as seen in echocardiography, or other imagistic methods. Due to the lack of hemodynamic impairment, and consequently with few or no symptoms, this vascular anomaly is frequently discovered incidentally. In this brief report we present the case of a 35-year-old male known with a complex congenital cardiovascular malformation that included atrial septum defect, persistent left superior vena cava and anomalous right pulmonary vein drainage in the PLSVC, diagnosed with sinoatrial block that required pacemaker implantation. Due to the patient’s medical history, investigations to decide the best approach needed for pacemaker implantation were performed, including a thoracic CT that incidentally found additional anomalies — the hemiazygos vein draining in PLSVC and the lack of the left brachiocephalic vein.

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