Operative technique for persistent left superior vena cava draining into the left atrium

Surgical Correction of Common Atrium without Noncardiac Congenital Anomalies

“…There were 14 such cases in our cohort, including four whose LSVC drained into the coronary sinus of the right atrium, and 10 whose LSVC drained into the left atrium. There are four methods that may be used to deal with an LSVC draining into the left atrium: (1) Simple ligation; the indications for this were: (i) patients with small LSVC; (ii) an LSVC pressure <30 mmHg in a blocking test; (iii) abundant collateral branch vessels between the two superior vena cavae; (iv) caliber of the right superior vena cava more than 2/3 that of the LSVC. (2) Making a tunnel in the superior wall of the left atrium to drain blood into the right atrium .…”

“…(2) Making a tunnel in the superior wall of the left atrium to drain blood into the right atrium . (3) Using a large pericardial patch or artificial patch to separate the mitral valve, left atrial appendage, and pulmonary vein into the left side of the CA, and the right superior vena cava, inferior vena cava, and LSVC into the right side . However, it is important that the volume of the left atrium is not too small, and that the interatrial baffle does not become a partial obstruction to left ventricular inflow.…”

“…However, it is important that the volume of the left atrium is not too small, and that the interatrial baffle does not become a partial obstruction to left ventricular inflow. (4) If the LSVC could not be ligated, the LSVC opened into the lateral wall of the left atrium, the left pulmonary vein was near the mitral annulus, or the interatrial baffle would influence the flow between the pulmonary vein to the mitral valve, the LSVC may be connected to the right atrial appendage, using the atrial wall or the right atrial appendage as a conduit to extend the connection for drainage of the LSVC to the right atrium …”

Left superior vena cava connection to unroofed coronary sinus associated with positional cyanosis: Successful transcatheter treatment using Gianturco-Grifka vascular occlusion device

“…Cerebral emboli and abscess have been reported in patients with this anomaly [5,11]. Surgical techniques have included ligation of the LSVC, ligation combined with autologous pericardial patch augmentation of a hypoplastic innominate vein [12], intra-atrial baffling or tunneling techniques [11,13], and extracardiac anastomosis of the LSVC to the right atrial appendage, right superior vena cava, or ipsilateral pulmonary artery [14]. The selection of procedure depends on the details of the cardiac anatomy.…”

Left Superior Vena Cava Draining into the Left Atrium, Associated with Partial Anomalous Pulmonary Venous Connection: Surgical Correction

“…Persistent left superior vena cava (LSVC) connecting to the coronary sinus associated with atrial septal defect (ASD) is a common anomaly, but rarely, approximately in the 8% of the cases, 1 it connects to the left atrium through the left atrial appendage causing a right‐to‐left shunt responsible for cyanosis and heart failure.The patient's anatomic characteristics determine the surgical technique of repair. If the LSVC is connected to the right superior vena cava by a left innominate vein of adequate size, the simple ligation is feasible.…”