Aortic valve stenosis causing a left-to-right shunt in persistent left superior vena cava communicating with the left atrium

Abstract

This study demonstrated a rare anomaly of a persistent left superior vena cava draining into the left atrium in a patient with developing left-to-right shunt caused by bicuspid aortic stenosis. The venous system, including the coronary sinus, was otherwise normal. We believe that, in this anatomic situation, a marked increase in left ventricular impedance caused a moderate left-to-right shunt from the left atrium into the left innominate vein. At operation, the aortic valve was replaced with a mechanical prosthesis and the anomalous vein was ligated. The convalescence was uneventful.

The usefulness of contrast echocardiography for detecting right-to-left cardiac shunts during the diagnosis of hypoxemia: 2 case reports

“…Because this anomaly is very rare, the therapy for it is not established. Several reports recommend PLSVC repair by simple ligation or using a patch [4][5][6]. However, as the PLSVC was linked to the right superior vena cava in case 1, only a patch repair was considered.…”

Physiological impact and transcatheter treatment of the persisting left superior caval vein

“…2 Alternatively when seen in association with obstructive lesions of the left heart, the shunting may be left-to-right. 3,4 Such shunts can be masked by associated cardiac lesions, and may manifest only after surgical repair. Presentation can be with inappropriate systemic desaturation during or after staged functionally univentricular palliation.…”

“…When connected appropriately to the right heart, its presence may be inconsequential. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] Transcatheter 9, [16][17][18] and surgical intervention are well established for treatment of the vein 6,[19][20][21][22][23][24][25] . In this review, we illustrate the options in the setting of 3 cases, 1 in the absence of, and 2 in association with, complex cardiac lesions.…”