Abstract
An 88-year-old male presented for a routine transthoracic echocardiogram. Dilated coronary sinus was noted, raising the suspicion for persistent left superior venous cava (PLSVC). An agitated saline study from the left upper extremity demonstrated a flow through the coronary sinus into the right ventricle in a parasternal long-axis view. A venogram from the right internal jugular vein showed the PLSVC drained into a much dilated coronary sinus (CS) that connected to the right atrium. The right superior vena cava was absent. PLSVC along with absent right superior vena cava is rare and the inadvertent CS cannulation may result in vessel perforation.
Highlights
Case An 88-year-old male with aortic stenosis status post bioprosthetic valve replacement presented for routine transthoracic echocardiography (TTE) to evaluate shortness of breath
A dilated coronary sinus was noted during examination raising the suspicion of a persistent left superior venous cava (PLSVC), (Fig-1, Video-1) so an agitated saline study was carried out
An intravenous catheter was placed in the left antecubital vein and agitated saline was injected, demonstrating flow through the coronary sinus into the right ventricle, in parasternal long- axis view (Fig-2, Video-2)
Summary
Keywords Congenital Anomaly, Venous Anomaly, Transthoracic Echocardiogram Case An 88-year-old male with aortic stenosis status post bioprosthetic valve replacement presented for routine transthoracic echocardiography (TTE) to evaluate shortness of breath. A dilated coronary sinus was noted during examination raising the suspicion of a persistent left superior venous cava (PLSVC), (Fig-1, Video-1) so an agitated saline study was carried out. An intravenous catheter was placed in the left antecubital vein and agitated saline was injected, demonstrating flow through the coronary sinus into the right ventricle, in parasternal long- axis view (Fig-2, Video-2).
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