Left superior vena cava: revisited
Open Access
- 2 February 2012
- journal article
- case report
- Published by Oxford University Press (OUP) in European Heart Journal – Cardiovascular Imaging
- Vol. 13 (4), 284-291
- https://doi.org/10.1093/ehjci/jes017
Abstract
The persistence of a left-sided superior vena cava is the most common variant of systemic venous drainage. Increased utility of cardiac imaging, in particular cross-sectional techniques such as computed tomography and magnetic resonance (MR), will result in increased detection of the anomaly and its variants. Whilst in the typical form it is often haemodynamically insignificant, its discovery may have clinical significance nonetheless, and its mimics require exclusion. During cardiac development the anomaly results from a failure of the left anterior cardinal vein to obliterate. Recognized anatomical variants include the absence of the right superior vena cava and of an innominate bridging vein. Typical drainage is to the coronary sinus, dilatation of which may be the first hint to the anomaly. Clinical implications with respect to vascular access and arrhythmia are well described. A significant minority drain into the left atrium, potentially creating a haemodynamically significant lesion. Additionally, differentiation from anomalous left upper pulmonary venous drainage via a vertical vein is mandatory. A newly discovered variant runs an intra-atrial course with subsequent typical drainage, and if not recognized as such, may be confused with a left atrial mass. The use of 3D contrast-enhanced MR venography has proven extremely helpful in characterizing anomalous vasculature, and we demonstrate how such techniques can help delineate the anomaly and differentiate from its mimics.Keywords
This publication has 28 references indexed in Scilit:
- Left superior vena cava in pediatric cardiology associated with extra-cardiac anomaliesInternational Journal of Cardiology, 2008
- Persistent left superior vena cava: Case reports and clinical implicationsInternational Journal of Cardiology, 2006
- Percutaneous closure of a persistent left superior vena cava connected to the left atriumInternational Journal of Cardiology, 2006
- Persistent left superior vena cava. Use of an innominate vein between left and right superior caval veins for the placement of a right ventricular lead during ICD/CRT implantationEuropean Heart Journal, 2005
- Routine breath-hold gradient echo MRI-derived right ventricular mass, volumes and function: accuracy, reproducibility and coherence studyThe International Journal of Cardiovascular Imaging, 2004
- Partial anomalous pulmonary venous drainage of the left upper lobe vs duplication of the superior vena cava: distinction based on CT findings.American Journal of Roentgenology, 1993
- Congenital anomalies of the superior vena cava: A CT studySeminars in Roentgenology, 1989
- Venous anomalies of the coronary sinus: detection by M-mode, two-dimensional and contrast echocardiography.Circulation, 1979
- Termination of Left Superior Vena Cava in Left Atrium, Atrial Septal Defect, and Absence of Coronary SinusCirculation, 1965
- Persistent Left Superior Vena CavaAngiology, 1954