Complicated implant in a patient with suspected dextrocardia and persistence of upper left vena cava: physiological considerations and implant issue

Abstract Background While it is the most common thoracic venous anomaly, a persistent left vena cava superior may present in atypical variations, which are important to consider during clinical management. Case presentation Here we report a 35-year-old Caucasian female patient with drainage into the left atrial appendage who presented with shortness of breath accompanied by mild hypoxemia. Venous contrast filling in the context of pulmonary scintigraphy suspected an additional superior caval vein connected to the left atrial appendage. Diagnosis was confirmed by transesophageal echocardiography. Cardiac catheterization revealed a minor right-to-left shunt. The symptoms could be allocated to a bronchial asthma and treated according to guidelines. Cerebral lesions detected in the patient were due to a coincident multiple sclerosis rather than cerebral embolisms. Thus, the venous anomaly was classified as an incidental finding currently requiring no treatment. Conclusions To the best of our knowledge, this is the first report of a persistent left vena cava superior draining into the left atrial appendage.

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Complete right-to-left shunt on lung perfusion SPECT results in the detection of a persistent left vena cava superior draining to the left atrium

Journal of the Belgian Society of Radiology ◽

10.5334/744 ◽

2012 ◽

Vol 95 (5) ◽

pp. 334

Author(s):

G Ceulemans ◽

H Everaert ◽

D Verdries ◽

T Lahoutte ◽

B Ilsen

Keyword(s):

Left Atrium ◽

Vena Cava ◽

Lung Perfusion ◽

Vena Cava Superior ◽

Left Vena ◽

Perfusion Spect

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Vein of Marshall (ligament of left vena cava)(用語解説)

Journal of JCS Cardiologists ◽

10.1253/jjcsc.20.2_280 ◽

2012 ◽

Vol 20 (2) ◽

pp. 280-280

Keyword(s):

Vena Cava ◽

Left Vena

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Neurological Symptoms as a Showcase of the Inborn Anomaly in a Development of the Arterial and Venous Vessels (Case Report)

Medical Visualization ◽

10.24835/1607-0763-2017-6-25-29 ◽

2017 ◽

pp. 25-29

Author(s):

A. I. Tyunibabyan ◽

A. A. Mukhin

Keyword(s):

Case Report ◽

Aortic Arch ◽

Special Interest ◽

Vascular System ◽

Vena Cava ◽

Diagnostic Methods ◽

Vena Cava Superior ◽

Left Vena ◽

Cardio Vascular ◽

Combined Defects

Inborn specific anomalies in the development of the cardio-vascular system require strong attention from physicians of many specialties, especially during diagnosing process. The results of all available diagnostic methods of patient examination determine the further treatment tactic. This tactic implying an individual approach to a specific pathology. There are some cases of combined defects of both, the arterial as well as the venous systems, which appealing special interest. This article describes case report of such anomalies in the structure of the vascular system. This case shown in the form of congenital inflection of the aortic arch with true coarctation and the persistent left vena cava superior.

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Paradoxical Electrocardiographic Rhythm During Peripherally Inserted Central Catheter Insertion from Persistent Left Superior Vena Cava

Journal of the Association for Vascular Access ◽

10.1016/j.java.2016.10.093 ◽

2017 ◽

Vol 22 (1) ◽

pp. 15-18

Author(s):

Nicholas Mifflin ◽

Vanno Sou ◽

Evan Alexandrou ◽

Antony Stewart ◽

Jules Catt

Keyword(s):

Superior Vena Cava ◽

Superior Vena ◽

Vena Cava ◽

Gas Analysis ◽

Arterial System ◽

Peripherally Inserted Central Catheter ◽

Central Catheter ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

Left Vena

Abstract Introduction: A persistent left superior vena cava is one of the most common thoracic vascular anomalies, present in approximately 0.5% of the general population. The most common presentation is both a right and left superior vena cava, communicating through an innominate vein. In rare cases, complete absence of a right sided superior vena cava may have dispersion of pacemaker and conduction tissue leading to abnormal electrocardiography readings. Case Description: This case report describes the insertion of a peripherally inserted central catheter via the right basilic vein utilising ultrasound and electrocardiographic guidance during which atypical P-waves were noted. Post procedure chest x-ray found the catheter to be positioned to the left side of the chest. Discussion and Evaluation: Initial management was to assess whether the catheter was placed in the arterial system. Catheter transduction and blood gas analysis demonstrated the peripherally inserted central catheter was situated in the venous system. Computer tomography was then used to assess the patient's vasculature, demonstrating a persistent left vena cava with absence of a right vena cava. Conclusion: This case describes the successful placement of a right basilic peripherally inserted central catheter in a patient with a persistent left vena cava with an absent right superior vena cave using ultrasound and electrocardiographic guidance.

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