Persistent left superior vena cava (PLSVC) is the most common venous anomaly of the thorax affecting 0.5-2% of the general population. PLSVC with absent right SVC, which is also referred to as isolated PLSVC, occurs in 0.09-0.13% of patients. PLSVC should be suspected whenever a dilated coronary sinus is discovered on transthoracic echocardiography. Transthoracic echocardiography serves as an excellent modality to diagnose PLSVC. The presence of PLSVC can be confirmed by performing a bilateral "bubble study" with injection of agitated saline from both the left and the right peripheral arm veins. Although PLSVC is a benign condition, it may have important clinical implications in certain situations. We describe a case of PLSVC with an absent right SVC followed by a review of the literature and the clinical implications associated with this condition.
A chest radiograph may show widening of the aortic contour; other features may include displaced calcification, aortic kinking, or opacification of the aortopulmonary window.
a b s t r a c tMyocardial perforation is a rare complication of permanent pacemaker implantation. While most of the perforations occur at the time of implantation or within the first 24 h, delayed myocardial perforations are very rare. The clinical course is extremely variable with some patients presenting completely asymptomatic, while others can develop cardiac tamponade and haemodynamic instability. We report an unusual case of a subacute ventricular perforation caused by a passive-fixation lead two weeks after implantation and we successfully managed to extract the lead under local anaesthesia, without the patient undergoing surgery, as recommended in the previously published reports.
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