Double left innominate vein: an unusual cross-sectional echocardiographic appearance

Subirana, María Teresa; Leval, Marc de; Somerville, Jane

doi:10.1016/0167-5273(86)90251-2

Cited by 16 publications

(20 citation statements)

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“…Anomalous subaortic left brachiocephalic vein (ASLBV) is a rare systemic venous anomaly (Kitamura et al, 1981;Shaffer et al, 1985;Smallhorn et al, 1985;Subirana et al, 1986). However, noninvasive imaging examinations, including echocardiography (Choi et al, 1990;Curtil et al, 1999; *Correspondence to: Mitsugi Nagashima, MD, Department of Surgery, Stroke and Cardiovascular Center, Ehime University Hospital, Shitsukawa, Toon City, Ehime 791-0295, Japan.…”

Section: Introductionmentioning

confidence: 95%

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

et al. 2010

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Anomalous subaortic left brachiocephalic vein (ASLBV) is a rare systemic venous anomaly. We review our experience with patients associated with ASLBV who underwent cardiac surgery at three institutions. From 1989 to 2009, the medical records of surgically treated patients with ASLBV were analyzed; the incidence of ASLBV, clinical characteristics, and associated anatomical findings were assessed. Fifteen patients had ASLBV. All ASLBVs coursed left lateral to the aortic arch, passed under the ascending aorta anterior to the central pulmonary artery, and joined the right brachiocephalic vein. Fourteen patients had congenital heart disease (CHD), and the remaining patient did not have cardiac anomalies. Its incidence was 0.57% (14 of 2,449) in patients with CHD and only 0.02% (1 of 4,805) in patients without CHD. In patients with CHD, 73.3% (11 of 15) of the patients had conotruncal cardiac anomalies such as tetralogy of Fallot, ventricular septal defect with pulmonary atresia, truncus arteriosus, and interruption of the aortic arch. Eight patients had aortic arch anomalies, including right aortic arch and cervical aortic arch. The deletion of chromosomal 22q11.2 was confirmed in two patients, and one patient was diagnosed with DiGeorge syndrome. ASLBV was clinically silent even without any surgical intervention. ASLBV is a very rare anomaly and is highly associated with conotruncal cardiac anomalies and aortic arch anomalies, including right aortic arch and cervical aortic arch. Preoperative diagnosis is important when any surgical interventions are intended, especially, in patients with conotruncal cardiac anomalies.

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Section: Introductionmentioning

confidence: 95%

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

et al. 2010

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“…12,13 We encountered 6 descriptions of the duplication of the vein, the branches encircling the aorta, and one report of persistent left superior caval vein with duplication of the left brachiocephalic vein. 17,31,43,[45][46][47] In one of the cases, the anterior and thinner vein coursed above the aortic arch, anterior to left common carotid artery, and then passed between the left common carotid artery and brachiocephalic trunk to join the right superior caval vein. The posterior thicker retroaortic vein coursed posterior to trachea and esophagus and joined the azygous vein at the level of the second thoracic vertebra before draining to the right superior caval vein.…”

Section: Surgical Anatomymentioning

confidence: 99%

“…Three-dimensional computed tomographic angiocardiography, and magnetic resonance imaging, are helpful in ascertaining the diagnosis, and in demonstrating the relationship of the vein to the adjacent structures (Figures 1A-1F, 3A-3C, 4A-4C). [3][4][5]9,10,14,15,17,22,25,[27][28][29][32][33][34][35][36][43][44][45][46]59,69 Cardiac catheterization and angiography may still be indicated in doubtful cases, and for evaluation of associated cardiac anomalies. 13,20,28,48,55,57,74 Computed tomography and magnetic resonance imaging similarly come into their own for the assessment of associated lesions.…”

Section: Demographicsmentioning

confidence: 99%

“…31 The sixth pattern is produced by duplication of the vein (Figure 5G). 31,43 There is then additional variation in the setting of duplication. The anterior vein has been described as passing above the aortic arch and coursing anterior to the left common carotid artery and brachiocephalic arteries, before draining into the superior caval vein.…”

Section: Surgical Anatomymentioning

confidence: 99%

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Surgical Management of Lesions encountered in the Setting of the Retroaortic Left Brachiocephalic Vein

Chowdhury

Anderson

Sankhyan

et al. 2021

Preprint

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The present perspective is a synthesis of 80 published investigations in the setting of a retroaortic left brachiocephalic vein, described in 250 patients. Clinical presentation, radiographic findings, ultrasonographic findings, saline contrast echocardiography, computed-tomographic angiocardiography, magnetic resonance imaging, and angiocardiography provided the diagnostic information used to define the disease entity prior to considering the surgical approach to the associated cardiac anomalies. We have also addressed several issues concerning the influence of isomerism, the establishment of diagnosis, and its importance in various surgical and interventional procedures. Although the retroaortic left brachiocephalic vein is asymptomatic, its recognition during clinical investigation should raise the possibility of an association with other malformations, especially right aortic arch, ventricular septal defect, and anomalies of the outflow tracts. We submit that an increased appreciation of this venous anomaly may facilitate surgical planning, endovascular procedures, placement of central venous lines, and transvenous pacemakers.

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“…Double LIV is an exceedingly rare systemic venous anomaly, which causes diagnostic confusion on echocardiography . This confusion has led to cardiac catheterization and angiography for delineation of the anatomy . Correct diagnosis is essential before performing any invasive procedure through this vein such as implantation of a pacemaker, cardiac implantable electronic device, or central venous catheterization.…”

mentioning

confidence: 99%

Circumaortic double left innominate vein: Two novel echocardiographic diagnostic clues for a tricky diagnosis

Rad

2018

Echocardiography

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We report a 7-year-old boy with unilateral choanal atresia who was referred for cardiac consultation before surgery. On echocardiography, the heart was normal except the presence of a double-circle appearance and a V-shaped structure on the suprasternal notch view. Cardiac computed tomography (CT) angiography confirmed the diagnosis of the double left innominate vein (DLIV). DLIV is a rare systemic venous anomaly, which often produces diagnostic confusion on echocardiography. Correct diagnosis is essential before performing any invasive procedure through this vein. Co-existence of the two echocardiographic signs of the double-circle appearance and the V sign confirms this tricky diagnosis.

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Double left innominate vein: an unusual cross-sectional echocardiographic appearance

Cited by 16 publications

References 0 publications

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

Anomalous subaortic left brachiocephalic vein in surgical cases and literature review

Surgical Management of Lesions encountered in the Setting of the Retroaortic Left Brachiocephalic Vein

Circumaortic double left innominate vein: Two novel echocardiographic diagnostic clues for a tricky diagnosis

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