A Rare Anomalous Systemic Venous Return With Bilateral Absence of Superior Vena Cava

Abstract

The Video can be viewed in the online version of this article [10.1016/j.athoracsur.2021.02.056] on http://www.annalsthoracicsurgery.org. The Video can be viewed in the online version of this article [10.1016/j.athoracsur.2021.02.056] on http://www.annalsthoracicsurgery.org. A 24-month-old boy, who had history of abnormal echocardiograms showing possible anomalous systemic venous return, underwent cardiac magnetic resonance imaging (MRI) for further evaluation. Cardiac MRI confirmed bilateral absence of the superior vena cava (SVC). The right subclavian vein (RSV) and the right jugular vein (RJV) drain into the azygos vein (AV) (4.8-mm diameter), which courses inferiorly. The left subclavian vein (LSV) and the left jugular vein (LJV) drain into the hemiazygos vein (HAV) (7.7 × 6.6 mm diameter), which also courses inferiorly and is dominant. The hemiazygos and azygos veins join together at approximately T9 (asterisks), the level of the diaphragm into a single dominant vein to the left of the midline. This anomalous vein courses inferiorly from T9 to approximately the L1 level (12.2 × 6.6 mm diameter at T12) and then loops superiorly and to the right to join the prominent inferior vena cava (IVC) above the level of the renal veins (Figure 1; Video). Figure 1 is the posteroanterior (PA) view. The aorta (Ao) looks small in the images because of the timing of the image acquisition. Congenital anomalies of the SVC are rare and often coexist with other cardiac abnormalities.1Oliveira J.D. Martins I. Congenital systemic venous return anomalies to the right atrium review.Insights Imaging. 2019; 10: 115Crossref PubMed Scopus (19) Google Scholar Total absence of the SVC is a very rare anomaly, and we present 3-dimensional MRI images of this anomaly. https://www.annalsthoracicsurgery.org/cms/asset/51dac1ee-4da9-46a3-a866-6767ee5e74eb/mmc1.mp4Loading ... Download .mp4 (0.89 MB) Help with .mp4 files Video