Persistent left superior vena cava and cardiac transplantation: Anterior rerouting with anastomosis to the right atrium

Persistent Left Superior Vena Cava in a Heart Transplant Recipient’s Native Heart: A Rare Case Diagnosed by Transesophageal Echocardiogram

“…The cases of PLSVC in native hearts of heart transplant recipients that have been reported in the surgical literature primarily focused on the surgical technique. 3,6-8 To the best of our knowledge, a similar finding in the native heart of patients undergoing an orthotopic heart transplant has not been reported in anesthesia literature.…”

Bicaval orthotopic heart transplantation in a patient with persistent left superior vena cava

“…PLSVC may occur with many anatomical variations, the majority of cases are asymptomatic, and it is usually diagnosed during surgery. 1 , 2 …”

“…PLSVC may occur with many anatomical variations, the majority of cases are asymptomatic, and it is usually diagnosed during surgery. 1,2 Written informed consent was obtained from the patient, and the study was approved by the institutional review board on May 13, 2020 (registration number [CAAE]: 31367720.5.0000.5201). A 21-year-old woman with idiopathic dilated cardiomyopathy and significant pulmonary arterial hypertension received a heart transplant in our department.…”

Commentary: Cardinal principles

“…5 Their results, as illustrated in the intraoperative and 3-dimensional reconstructions, are enviably unobstructed, albeit quite similar to the techniques reported previously. 6 , 7 As they noted, although a common practice in the absence of a bridging vein has been to baffle the left-sided systemic venous return at transplantation with a donor innominate vein, not infrequently this can lead to obstruction if placed either in front of, or behind, the aortic anastomosis (even despite intentional adjustments in the size of the neo-ascending aorta).…”