Echocardiography of the superior vena cava

Abstract

SummaryThe anatomy and applied echocardiographic anatomy of the superior vena cava (SVC) are briefly described. Right supraclavicular interrogation of the SVC has been in use for many years, but supraclavicular two-dimensional (2-D) imaging of the SVC has been virtually ignored. We have recently shown that supraclavicular 2-D imaging can provide excellent views of the SVC and its main tributaries. Transthoracic echocardiography (TEE) is suitable for imaging of the lower (juxtaatrial) SVC. Persistence of a left SVC is an uncommon variant, diagnosed echocardiographically by coronary sinus dilatation and passage of contrast into it from a left arm vein. Extensive SVC compression by mediastinal masses is well known, but recently intravascular SVC obstruction has been increasingly reported as a complication of radiofrequency ablation for ectopic atrial tachycardia, for thrombosis of the SVC or its main tributaries following indwelling catheters, or following insertion of pacemaker leads. Doppler interrogation or TEE imaging of the SVC have been used in recent years to elucidate such pathology.

Bedside Ultrasound can Safely Eliminate the Need for Chest Radiographs after Central Venous Catheter Placement: CVC Sono in the Surgical ICU (SICU)

“…Vascular, cardiac, and thoracic ultrasound examinations performed by non-cardiologists are considered feasible diagnostic modalities [21][22][23][24]. On the other hand, because of difficulty in visualizing the superior vena cava, especially the lower part of SVC at the cavoatrial junction, transthoracic echocardiography (TTE) has not been well described compared with transesophageal echocardiography (TEE), a more accurate modality to localize the tip of central venous catheters [25,26].…”

Superior vena cava–right atrium junction flow‐pattern post‐transcatheter closure of patent foramen ovale

“…To assess the SVC‐RA junction flow, we used the PW Doppler which is known as a sensitive and accurate method for assessing right heart filling dynamic …”

“…Superior vena cava forward flow may be accurately assessed by Doppler echocardiography, which typically shows biphasic pattern with systolic greater than diastolic flow velocity . The SVC tracing values in the normal subjects are influenced by age, gender, and respiration .…”

Doppler Superior Vena Cava Flow Evolution and Respiratory Variation in Superior Vena Cava Syndrome

“…It can also be displayed as a complication of mediastinal tuberculosis 7 . The delivery of multiple radiofrequency (RF) ablation lesions, often necessary for cure of inappropriate sinus tachycardia (IST), can cause considerable atrial swelling and resultant narrowing of the SVC‐RA junction 1 …”

“…Right supraclavicular approach With the transducer placed in the fossa between the sternal and clavicular heads of the sternomastoid muscle and with the patient lying supine, the upper part of the SVC and its adjacent structures were fully displayed 1 …”