Double Left Brachiocephalic Vein in an Adult Patient Who Underwent Cardiac Surgery: A Case Report

Abstract Background: A double left brachiocephalic vein is an extremely rare venous anomaly. Case presentation: Herein, we present the case of a 79-year-old woman with a double left brachiocephalic vein who underwent cardiac surgical procedures. The normal left brachiocephalic vein was patent, and the accessory left brachiocephalic vein passed across the heart and aorta in front of the pericardium and drained into the superior vena cava. She underwent surgical ligation of the accessory left brachiocephalic vein, followed by an aortic valve replacement and coronary artery bypass grafting. Her postoperative recovery was uneventful, without any venous complications from the ligation of the accessory vein. The patient is doing well one year after the surgery.Conclusions: The presence of double left brachiocephalic veins should be recognized before cardiac surgery in order for us to avoid intraoperative technical issues concerning this venous anomaly and unpredictable intraoperative bleeding due to injury of the accessory left brachiocephalic vein.

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Double left brachiocephalic vein in an adult patient who underwent cardiac surgery: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01630-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Kimihiro Kobayashi ◽

Tetsuro Uchida ◽

Yoshinori Kuroda ◽

Atushi Yamashita ◽

Eiichi Ohba ◽

...

Keyword(s):

Cardiac Surgery ◽

Superior Vena ◽

Artery Bypass ◽

Vena Cava ◽

Cardiac Surgical Procedures ◽

Postoperative Recovery ◽

Brachiocephalic Vein ◽

Venous Anomaly ◽

Left Brachiocephalic Vein ◽

One Year

Abstract Background A double left brachiocephalic vein is an extremely rare venous anomaly. Case presentation Herein, we present the case of a 79-year-old woman with a double left brachiocephalic vein who underwent cardiac surgical procedures. The normal left brachiocephalic vein was patent, and the accessory left brachiocephalic vein passed across the heart and aorta in front of the pericardium and drained into the superior vena cava. She underwent surgical ligation of the accessory left brachiocephalic vein, followed by an aortic valve replacement and coronary artery bypass grafting. Her postoperative recovery was uneventful, without any venous complications from the ligation of the accessory vein. The patient is doing well one year after the surgery. Conclusions The presence of double left brachiocephalic veins should be recognized before cardiac surgery in order for us to avoid intraoperative technical issues concerning this venous anomaly and unpredictable intraoperative bleeding due to injury of the accessory left brachiocephalic vein.

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Aberrant left brachiocephalic vein is a contraindication for anterior cervicothoracic approach

Journal of Orthopaedic Surgery ◽

10.1177/2309499019879213 ◽

2019 ◽

Vol 27 (3) ◽

pp. 230949901987921

Author(s):

Edwin Kean Siong Ong ◽

Tat Seng Wong ◽

Weng Hong Chung ◽

Chee Kidd Chiu ◽

Aik Saw ◽

...

Keyword(s):

Superior Vena ◽

Vena Cava ◽

Rare Condition ◽

Posterior Spinal Fusion ◽

Brachiocephalic Vein ◽

Left Brachiocephalic Vein ◽

Significant Correction ◽

Upper Thoracic ◽

Neurovascular Structures ◽

Fibula Strut

Aberrant left brachiocephalic vein is a rare condition. Its occurrence in patients requiring anterior cervicothoracic approach for severe kyphoscoliosis has not been described. A 16-year-old male with neurofibromatosis and severe upper thoracic kyphoscoliosis presented to us with curve progression. Halo gravity traction was attempted but failed to achieve significant correction. Subsequently, he underwent halo-pelvic traction and later Posterior Spinal Fusion (PSF) from C2 to T10. Second-stage anterior cervicothoracic approach with anterior fibula strut grafting was planned; however, preoperative computed tomography angiography revealed an aberrant left brachiocephalic vein with an anomalous retrotracheal and retroesophageal course, directly anterior to the T5/T6 vertebrae (planned anchor site for fibula strut graft) before draining into superior vena cava. Therefore, surgery was abandoned due to the risks associated with this anomaly. Aberrant left brachiocephalic vein is rare, the presence of which could be a contraindication for anterior cervicothoracic approach. Assessment of the anterior neurovascular structures is crucial in preoperative planning.

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