Abstract
We report on a 74-year-old woman with an absence of right superior vena cava in visceroatrial situs solitus who underwent mitral valve plasty for severe mitral regurgitation. Preoperative three-dimensional computed tomography revealed an absent right and persistent left superior vena cava that drained into the right atrium by way of the coronary sinus. Perioperaively, placement of pulmonary artery catheter, site of venous cannulation, and management of associated rhythm abnormalities were great concern. Obtaining the information about this central venous malformation preoperatively, we performed mitral valve plasty without any difficulties related to this anomaly.
Highlights
Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) in visceroatrial situs solitus is an extremely rare congenital anomaly [1,2]
We report one patient with this anomaly who underwent mitral valve plasty for severe mitral regurgitation
A venous cannula can be inserted into PLSVC in either way: a cannula can be inserted from the coronary sinus, or an L-shaped cannula can be directly inserted into the PLSVC
Summary
Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) in visceroatrial situs solitus is an extremely rare congenital anomaly [1,2]. This anomaly can exist alone, and is difficult to diagnose because the hemodynamics of patients with this condition are normal and there may be lack of clinical symptoms. Transthorasic echocardiogram (TTE) at that time showed severe mitral regurgitation She was treated medically and had regular follow-up with serial echocardigrams. The postoperative course for the patient was uneventful and echocardiography showed only trivial mitral regurgitation
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