Persistent left superior vena cava the anatomical and surgical importance

Erdoğan, Mehmet Ali; Karakaş, Pınar; Uygur, F; Meşe, Bülent; Yamak, Birol; Bozkır, Memduha Gülhal

doi:10.1590/s0043-31442007000100013

Cited by 19 publications

(42 citation statements)

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“…As previously discussed, the venous return from the PLSVC drains into the left atrium in approximately 10% to 20% of cases [43,44,111]. This particular venous drainage pattern of PLSVC that results in venous return to the left atrium [34,40,43,44,65,81,92,98,100,111,113], as well as any other cardiac anomaly which results in right-to-left cardiac shunting, places those patients at a significant risk for subsequent paradoxical embolic complications to the arterial system, either from thromboemboli or air emboli, with resultant neurologic, cardiac, renal, mesenteric, and/or peripheral sequelae [34,40,44,65,81,92,98,100,111,113,135,136]. Therefore, it is essential that one fully characterizes, by venous imaging, the pattern of cardiac venous return (i.e., to the right atrium or to the left atrium) in any patient suspected of PLSVC at central venous access device placement prior to initiation of use of their central venous access device.…”

Section: Reviewmentioning

confidence: 99%

Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients

2011

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Persistent left superior vena cava (PLSVC) represents the most common congenital venous anomaly of the thoracic systemic venous return, occurring in 0.3% to 0.5% of individuals in the general population, and in up to 12% of individuals with other documented congential heart abnormalities. In this regard, there is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians actively involved in central venous access device placement in cancer patients. In the current review, we have attempted to comprehensively evaluate the available literature regarding PLSVC. Additionally, we have discussed the clinical implications and relevance of such congenital aberrancies, as well as of treatment-induced or disease-induced alterations in the anatomy of the thoracic central venous system, as they pertain to the general principles of successful placement of central venous access devices in cancer patients. Specifically regarding PLSVC, it is critical to recognize its presence during attempted central venous access device placement and to fully characterize the pattern of cardiac venous return (i.e., to the right atrium or to the left atrium) in any patient suspected of PLSVC prior to initiation of use of their central venous access device.

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Section: Reviewmentioning

confidence: 99%

Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients

2011

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“…PLSVC is the most frequent cause of enlargement of the coronary sinus. [2] Echocardiography with agitated saline (or other ultrasound contrast) can confirm the diagnosis of PLSVC. In this case, the diagnosis of PLSVC was also made by echocardiography with agitated saline.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided catheterization of the left subclavian vein without recognition of persistent left superior vena cava

Park¹,

Yoo²,

Kim³

et al. 2017

Medicine

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Rationale:A persistent left superior vena cava (PLSVC) is rare, but the most common thoracic venous anomaly. We report a case of PLSVC unrecognized during left subclavian vein catheterization using real-time ultrasound-guided supraclavicular approach.Patient concerns:A 79-year-old man with history of hypertension presented with traumatic subdural hemorrhage, subarachnoid hemorrhage, and epidural hemorrhage. Before the operation, a central venous catheter (CVC) was placed into the left subclavian vein.Diagnoses:A dilated coronary sinus on echocardiogram and subsequent agitated saline test confirmed the diagnosis of PLSVC.Interventions:A CVC was placed into the left subclavian vein under real-time ultrasound guide, with supraclavicular approach. A postoperative chest X-ray revealed a left-sided paramediastinal course of the CVC; the CVC was removed under the impression of malposition.Outcomes:The CVC functioned properly.Lessons:Ultrasound is used for safe and correct placement of CVC; however, the presence of PLSVC could not be detected by ultrasonography in this case. When the chest radiograph shows the central venous catheter passing along the border of the left heart and a dilated coronary sinus detected on echocardiogram, we should have suspicion of a PLSVC.

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“…Therefore, in patients with these syndromes one should search for persistent LSVC before intravenous line insertion (8). When persistent LSVC is present, it usually drains into the right atrium via coronary sinus in 92% of the cases (24). In our study it does so in all cases but one, in which it drained to the left atrium and had no significant effect on the saturation.…”

Section: Discussionmentioning

confidence: 99%

High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia

Eldin

El-Segaier

Galal

2013

Libyan Journal of Medicine

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BackgroundPersistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1–0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations.AimThe aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia.MethodsAll patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC.ResultsA total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7–18.2, p<0.001). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4–10.8, p<0.001).ConclusionsThe prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool.

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Persistent left superior vena cava the anatomical and surgical importance

Cited by 19 publications

References 0 publications

Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients

Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients

Ultrasound-guided catheterization of the left subclavian vein without recognition of persistent left superior vena cava

High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia

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