Authors

• Damir Raljević — Clinic for rehabilitation, treatment and prevention of diseases of the heart and blood vessels, Thalassotherapia Opatija, Croatia — ORCID: 0000-0001-9743-9201
• Karlo Stanić — Clinic for rehabilitation, treatment and prevention of diseases of the heart and blood vessels, Thalassotherapia Opatija, Croatia
• Vesna Pehar Pejčinović — Clinic for rehabilitation, treatment and prevention of diseases of the heart and blood vessels, Thalassotherapia Opatija, Croatia
• Viktor Peršić — Clinic for rehabilitation, treatment and prevention of diseases of the heart and blood vessels, Thalassotherapia Opatija, Croatia — ORCID: 0000-0003-4473-5431

Abstract

The persistent left superior vena cava is a rare vein anomaly and is encountered in 0.3-0.5% of the population, however, as these anomalies are usually asymptomatic, the prevalence is often underestimated (1). This anomaly is found in 12% of cases with other congenital heart disease. Several anatomical variants of this anomaly are described. In the largest number of cases (80-90%) there are developed both left and right superior vena cava that may differ in size (2). In the event that both vena cava equally developed, in 65% of cases the development of the left innominate vein is absent and there is no communication between the two superior vena cava. Then the persistent left vena cava drains into the right atrium through the coronary sinus (3). In 10-20% cases, the left superior vena cava drains into the left atrium. Also, in 10-20% cases, the right superior vena cava is not developed, and the single left superior vena cava is drained through the coronary sinus into the right atrium (3). In the vast majority of cases this anomaly is asymptomatic and goes unnoticed. Clinical relevance is found in the case of the central venous access and the placement of central venous devices, in which case it may be difficult or impossible to set up a central venous device or provoke potentially dangerous right-left shunt and potential thromboembolic incidents. During this presentation we intend to report a case of multimodal imaging of persistent left superior vena cava.

Keywords

left superior vena cava, imaging

DOI

Literature

1. Povoski SP, Khabiri H. 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. World J Surg Oncol. 2011 Dec 28;9:173. https://doi.org/10.1186/1477-7819-9-173
2. Couvreur T, Ghaye B. In: Integrated Cardiothoracic Imaging with MDCT from Medical Radiology · Diagnostic Imaging and Radiation Oncology series. 1. Rémy-Jardin M, Rémy J, editor. Berlin · Heidelberg: Springer-Verlag; 2009. Left superior vena cava; pp. 289–305.
3. Goyal SK, Punnam SR, Verma G, Ruberg FL. Persistent left superior vena cava: a case report and review of literature. Cardiovasc Ultrasound. 2008 Oct 10;6:50. https://doi.org/10.1186/1476-7120-6-50