Abstract
The 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 canprovide 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.
Keywords: two‐dimensional echocardiography, Doppler echocardiography, superior vena cava, thrombosis
Full Text
The Full Text of this article is available as a PDF (149.1 KB).
References
- 1. Shala MB, D'Cruz IA, Johns C, Kaiser J, Clark R: Echocardiography of the inferior vena cava, superior vena cava, and coronary sinus in right heart failure. Echocardiography 1998; 15: 787–794 [DOI] [PubMed] [Google Scholar]
- 2. Reynolds T, Appleton CP: Doppler flow velocity patterns of the superior vena cava, inferior vena cava, hepatic vein, coronary sinus, and atrial septal defect: A guide for the echocardiographer. J Am Soc Echocardiogr 1991; 4: 503–512 [DOI] [PubMed] [Google Scholar]
- 3. Gindea AJ, Slater J, Kronzon I: Doppler echocardiography flow velocity measurements in the superior vena cava during the Valsalva maneuver in normal subjects. Am J Cardiol 1990; 65: 1387–1391 [DOI] [PubMed] [Google Scholar]
- 4. Byrd BF III, Linden RW: Superior vena cava Doppler flow velocity patterns in pericardial disease. Am J Cardiol 1990; 65: 1464–1470 [DOI] [PubMed] [Google Scholar]
- 5. Biffi M, Boriani G, Frabetti L, Bronzetti G, Branzi A: Left superior vena cava persistence in patients undergoing pacemaker or cardioverter defibrillator implantation. Chest 2001; 120: 139–144 [DOI] [PubMed] [Google Scholar]
- 6. Badessa F, Pizzimenti G, Grasso P, Merlino A, Vasquez L: Persistent left superior vena cava and absence of right superior vena cava. Ital Heart J 2003; 4 (suppl): 424–427 [PubMed] [Google Scholar]
- 7. D'Cruz IA, Shala MB: Echocardiography of the coronary sinus in adults. Clin Cardiol 2000; 23: 149–154 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. Al‐Ahmari S, Chandrasekaran K, Brilakas E, Tahlil W, Dearani J, Malouf J, Gilman G, Seward JB, Tajik AJ: Isolated partial anomalous pulmonary venous connection: Diagnostic value of suprasternal color flow imaging and contrast echocardiography. J Am Soc Echocardiogr 2003; 16: 884–889 [DOI] [PubMed] [Google Scholar]
- 9. Callans DJ, Ren JF, Schwartzman D, Gottlieb CD, Chaudhry FA, Marchlinski FE: Narrowing of the superior vena cava‐right atrium junction during radiofrequency catheter ablation for inappropriate sinus tachycardia: Analysis with intracardiac echocardiography. J Am Coll Cardiol 1999; 33: 1667–1670 [DOI] [PubMed] [Google Scholar]
- 10. Nishino M, Tanouchi J, Ito T, Tanaka K, Aoyama T, Kitamura M, Nakagawa T, Kato J, Yamada Y: Echocardiographic detection of latent severe thrombotic stenosis of the superior vena cava and innominate vein in patients with a pacemaker: Integrated diagnosis using sonography, pulse Doppler, and color flow. Pacing Clin Electrophysiol 1997; 20: 946–952 [DOI] [PubMed] [Google Scholar]
- 11. Hammerli M, Meyer RA: Doppler evaluation of central venous lines in the superior vena cava. J Pediatr 1993; 122: 104–108 [DOI] [PubMed] [Google Scholar]
- 12. Sivaram CA, Craven P, Chandrasekaran K: Transesophageal echocardiography during removal of central venous catheter associated with thrombus in superior vena cava. Am J Cardiol Imag 1996; 10: 266–269 [PubMed] [Google Scholar]
- 13. Ayala K, Chandrasekaran K, Karalis DG, Parris TM, Ross JJ Jr: Diagnosis of superior vena caval obstruction by transesophageal echocardiography. Chest 1992; 101: 874–876 [DOI] [PubMed] [Google Scholar]
- 14. Mugge A, Daniel WG, Haverich A, Lichtlen PR: Diagnosis of noninfective cardiac mass lesions by two‐dimensional echocardiography: Comparison of the transthoracic and transesophageal approaches. Circulation 1991; 83: 70–78 [DOI] [PubMed] [Google Scholar]
- 15. Shapiro MA, Johnson M, Steven B: A retrospective experience of right atrial and superior vena caval thrombi diagnosed by transesophageal echocardiography. J Am Soc Echocardiogr 2002; 15: 76–79 [DOI] [PubMed] [Google Scholar]
- 16. Iuchi K, Nakamura Y, Ishikawa T, Kaseno K: Respiratory changes of superior vena cava flow velocity in old myocardial infarction with severe left ventricular dysfunction. J Cardiol 1988; 18: 99–104 [PubMed] [Google Scholar]