Abstract
Background: Persistent left superior vena cava (PLS VC) is the most common thoracic venous anomaly.
Hypothesis: This study examines the epidemiologic, clinical, and morphologic characteristics of a cohort of patients with PLSVC draining into the coronary sinus.
Methods: We examined the clinical and morphologic characteristics of patients with PLSVC draining into the coronary sinus diagnosed at a single referral hospital for a defined population in northwestern Spain. We designed a prospective study of the case records of all patients diagnosed with PLSVC draining into the coronary sinus at the echocardiog‐raphy laboratory of the Hospital Xeral‐Calde from January 2001 through December 2002. Patients were included if they had a PLSVC diagnosed by transthoracic echocardiogram (TTE) using an echo‐contrast enhancement and confirmed by a magnetic resonance (MR) imaging. Ten patients (6 women) fulfilled the inclusion criteria described above. All patients were adults and had associated heart disease, including a congenital heart disease in three cases.
Results: Magnetic resonance imaging examination confirmed the presence of PLSVC and the site of drainage into the coronary sinus. Absence of the right superior vena cava was observed only in three patients, in whom the main coronary sinus size was significantly increased. Absence of the left bra‐chiocephalic vein was diagnosed in five patients.
Conclusion: This study describes 10 new cases of PLSVC and supports the necessity of considering PLSVC draining into the coronary sinus in the diagnosis of patients presenting with dilated coronary sinus diagnosed by TTE. It also underlines the important role of MR imaging in the evaluation of these abnormalities. An associated heart disease must always be excluded in these patients.
Keywords: left superior vena cava, coronary sinus, echocardiogram, echo‐contrast, magnetic resonance
Full Text
The Full Text of this article is available as a PDF (95.5 KB).
References
- 1. Brickner ME, Eichhorn EJ, Netto D, Cigarroa RG, Brogan WC III, Simonsen RL, Grayburn PA: Left–side inferior vena cava draining into the coronary sinus via persistent left superior vena cava: Case report and review of the literature. Cathet Cardiovasc Diag 1990; 20: 189–192 [DOI] [PubMed] [Google Scholar]
- 2. Sarodia BD, Stoller JK: Persistent left superior vena cava: Case report and literature review. Resp Care 2000; 45: 411–416 [PubMed] [Google Scholar]
- 3. Boussuges A, Ambrosi P, Gainnier M, Quenee V, Saint JM: Left‐sided superior vena cava: Diagnosis by magnetic resonance imaging. Intens Care Med 1997; 23: 702–703 [DOI] [PubMed] [Google Scholar]
- 4. Pai RG: Echocardiographic features of persistent left superior vena cava. Echocardiography 1999; 16: 435–436 [DOI] [PubMed] [Google Scholar]
- 5. Soward A, Ten Cate F, Fioretti P, Roelandt J, Serruys P: An elusive persistent left superior vena cava draining into left atrium. Cardiology 1986; 73: 368–371 [DOI] [PubMed] [Google Scholar]
- 6. Foale R, Bourdillon PD, Somerville J, Rickards A: Anomalous systemic venous return: Recognition by two‐dimensional echocardiography. Eur Heart J 1983; 4: 186–195 [DOI] [PubMed] [Google Scholar]
- 7. Gris P, Wilmet B, Benchillal A, Tack D, Wery D, De Jonghe M, Gillard C: Persistent left superior vena cava. Apropos of 2 cases. Rev Pneumol Clin 1995; 51: 33–35 [PubMed] [Google Scholar]
- 8. Biffi M, Boriani G, Frabetti L, Bronzetti G, Branzi A: Left superior vena cava persistence in patients undergoing pacemaker or cardioverter‐defibrillator implantation: A 10‐year experience. Chest 2001; 120: 139–144 [DOI] [PubMed] [Google Scholar]
- 9. Chan KL, Abdulla A: Giant coronary sinus and absent right superior vena cava. Heart 2000; 83: 704 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10. White CS, Baffa JM, Haney PJ, Pace ME, Campbell AB: MR imaging of congenital anomalies of the thoracic veins. Radiographics 1997; 17: 595–608 [DOI] [PubMed] [Google Scholar]
- 11. Webb WR, Gamsun G, Speckman JM, Kaiser JA, Federle MP, Lipton MJ: Computed tomographic demonstration of mediastinal venous anomalies. Am J Radiol 1982; 139: 157–161 [DOI] [PubMed] [Google Scholar]
- 12. Edwards JE, DuShane JW: Thoracic venous anomalies. Arch Pathol 1950; 49: 517–537 [PubMed] [Google Scholar]
- 13. Cha EM, Khoury GH: Persistent left superior vena cava: Radiologic and clinical significance. Radiology 1972; 103: 375–381 [DOI] [PubMed] [Google Scholar]
- 14. Campbell M, Deuchar DC: The left‐sided superior vena cava. Br Heart J 1954; 16: 423–439 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. Winters FS: Persistent left superior vena cava: Survey of the world literature and report of thirty additional cases. Angiology 1954; 5: 90–132 [DOI] [PubMed] [Google Scholar]
- 16. Pugliese P, Murzi B, Aliboni M, Eufrate S: Absent right superior vena cava and persistent left superior vena cava: Clinical and surgical considerations. J Cardiovasc Surg (Torino) 1984; 25: 134–137 [PubMed] [Google Scholar]
- 17. Dearstine M, Taylor W, Kerut EK: Persistent left superior vena cava: Chest X‐ray and echocardiographic findings. Echocardiography 2000; 17: 453–155 [DOI] [PubMed] [Google Scholar]
- 18. Morillas P, Frutos A, Valero R, Rodríguez JA, Bertomeu V: Persistent left superior vena cava. Rev Esp Cardiol 2000; 53: 1655 [DOI] [PubMed] [Google Scholar]