Drainage Of Left Superior Vena Cava Research Articles

Persistent Left Superior Vena Cava Draining Directly Into the Left Atrium With Occluded Coronary Sinus

Combined persistent left superior vena cava entering the left atrium with a congenitally atretic coronary sinus is a rare imaging finding. In the absence of a significant right-to-left shunt, it is generally asymptomatic and can be an incidental discovery. Assessing the anatomy of the cardiac vasculature is crucial before transcutaneous cardiac procedures. (Level of Difficulty: Intermediate.)

Classification and quantification of double superior vena cava evaluated by computed tomography imaging.

A double superior vena cava (DSVC) may cause technical difficulties in some cardiovascular procedures. However, no quantitative data exist to describe the morphological features of this anomaly. From January 2015 to January 2019, the data of 128 consecutive patients diagnosed with DSVC on computed tomography (CT) images were retrospectively analyzed. We proposed an easy and rational method for DSVC classification based on the presence or absence of the left brachiocephalic vein (LBCV), the presence or absence of an anastomotic vein bridging the bilateral superior vena cava (SVC), and the drainage pattern of the left superior vena cava (LSVC). The following classifications were established: type I, LBVC absent, LSVC drainage into the right atrium via the coronary sinus; type II, LBCV present, LSVC drainage into the right atrium via the coronary sinus; type III, LBCV absent, LSVC drainage into the right atrium via the anastomosis; type IV, LBCV present, LSVC drainage into the right atrium via the anastomosis. The length, diameter, and area of the bilateral SVC and the coronary sinus were carefully measured across the 4 types. Type I was the most frequently occurring type (66 of 128, 51.6%), followed by type II (43 of 128, 33.6%), then type III (15 of 128, 11.7%), and type IV (4 of 128, 3.1%). The LSVC was significantly longer than the right SVC (RSVC) in all 4 types, and the diameters of the LSVC were significantly larger in types without the LBCV (i.e., types I and III) (P<0.0001 for all). Additionally, the diameter of the coronary sinus in types I and II was triple that in types III and IV (P<0.0001), which was thought to be due to increased venous blood reflux through the coronary sinus. The anatomical features of DSVC can be satisfactorily depicted on CT. The quantitative measurement of this anomaly by the reporting radiologists could assist clinicians to minimize the procedure-associated risks.

Endoscopic Mitral Valve Repair in a Patient With Persistent Left Superior Vena Cava Draining Into the Coronary Sinus – Cannulation Technique and Surgical Management

Persistence of the left superior vena cava is often an incidental finding during cardiac surgical procedures. In minimally invasive valvular surgery, it may jeopardise venous drainage and myocardial protection. This How-To-Do-It paper describes the cannulation strategy in a case of minimally invasive mitral surgery in a patient with persistence of the left superior vena cava and absence of the anonymous vein detected with preoperative multimodality imaging.

A Failed CCHD Screen.

A Failed CCHD Screen.

Positional Hypoxemia from Persistent Left Superior Vena Cava Draining to the Left Atrium

Persistent left superior vena cava (PLSVC) is a relatively common congenital venous anomaly that typically drains into the coronary sinus without hemodynamic significance. Rarely a PLSVC drains directly into the left atrium... | Find, read and cite all the research you need on Tech Science Press

Surgical treatment of pediatric unroofed coronary sinus syndrome

Objective To analyze the clinical features and surgical treatment of unroofed coronary sinus syndrome(UCSS) in children, and to provide evidence for the diagnosis and treatment of such diseases during the perio-perative period. Methods A retrospective analysis was conducted based on the clinical data of 13 patients with UCSS, who underwent surgical treatment at Beijing Children′s Hospital Affiliated to Capital Medical University from January 2011 to December 2017.All 13 patients were complicated with persistent left superior vena cava(PLSVC) and other cardiac malformations; 7 patients were diagnosed preoperatively and 6 patients were diagnosed intraoperatively.Eleven cases were diagnosed type Ⅰ and 2 cases were type Ⅳ according to Kirklin′s classification.In all of 13 cases, atrial septal reconstruction was performed to drain the left superior vena cava(LSVC) to the right atrium, and other cardiac malformations were corrected at the same time. Results One patient died in this group, and the other 12 patients had early recovery after operation.Postoperative-ventilator-assisted time was 5-246 h(median 29 h) and hospital stay time was 8-40 d(median 16 d). The remaining 12 cases were followed up from 6 months to 7 years and 2 months.No death or complications occurred.No residual shunt or residual obstruction was found. Conclusions In the case of congenital heart disease with PLSVC, UCSS should be alerted.Atrial septal reconstruction and drainage of LSVC into right atrium in children with UCSS can achieve satisfactory surgical results. Key words: Child; Unroofed coronary sinus syndrome; Surgery; Persistent left superior vena cava

Right Atrial Flap Repair for Left Superior Vena Cava Draining into Left Atrium.

There are different surgical methods for the repair of persistent left superior vena cava that connects directly to the left atrium. We describe an extracardiac surgical technique that includes direct anastomosis of persistent left superior vena cava to the right atrium with right atrial flap and autologous pericardium. We have performed this procedure in four cases and there is no obstruction at postoperative control studies. Right atrial flap repair is a feasible extracardiac technique that offers growth potential.

Surgical Treatment of Dextroversion, Isolated Persistent Left Superior Vena Cava Draining Into the Left Atrium.

We report a rare case of dextroversion accompanied with atrial septal defect (ASD), persistent left superior vena cava with absent right superior vena cava in a four-year-old male. A polytetrafluoroethylene (PTFE) graft as an extracardiac conduit was used to connect the persistent left superior vena cava (PLSVC) with the right atrial appendage.

Persistent Left Superior Vena Cava Draining into Left Atrium as a Cause of Persistent Systemic Desaturation after Surgery

Persistent left superior vena cava (LSVC) is a rare congenital anomaly which usually produces no physiologic derangements if it drains into the right atrium via the coronary sinus, but it may cause significant desaturation when it drains into the left atrium (LA). Failure to diagnose LSVC communicating with the LA preoperatively may lead to serious consequences. We are describing an interesting case of a boy who presented with systemic desaturation due to an undetected LSVC after having undergone corrective surgery for atrioventricular canal defect. We have demonstrated that echocardiography with agitated saline contrast is a simple, accurate, and inexpensive diagnostic modality.

Chronic Cyanosis Due to Persistent Left Superior Vena Cava Draining into the Left Atrium in the Absence of a Coronary Sinus

We report a rare case of a 5-year-old child who presented with chronic hypoxemia and a normal cardiac examination, and was found to have a persistent left superior vena cava draining directly into the left atrium. The coronary sinus was absent. This case introduces a contradiction to the generally accepted concept that this anomalous connection can only occur in the presence of a partly or completely unroofed coronary sinus. High index of suspicion is required to include this pathology in the differential diagnosis for a patient with persistent cyanosis with normal cardiac examination.

An Anomalous Left Superior Venacava Draining into Left Atrium in association with Fetal Valproate Syndrome

Prenatal exposure of mother to valproic acid causes teratogenic effects on fetus. The authors report an 18 h-old girl with typical facial and limbs features of fetal valproate syndrome (FVS) along with abnormal draining of left superior vena cava into left atrium.

Left Hepatic Vein and Persistent Left Superior Vena Cava Drainage into the Coronary Sinus with Subaortic Valve Stenosis

Persistent left superior vena cava (PLSVC) and left hepatic vein drainage into the coronary sinus is a very rare combination of thoracic venous anomalies. A literature search revealed only two previously reported cases. PLSVC is associated with congenital heart disease and impulse conduction abnormalities. Subaortic valve stenosis is among these abnormalities. We present an extremely rare case of a 19-year-old woman who presented with PLSVC and left hepatic vein drainage into the coronary sinus associated with subaortic valve stenosis. The vascular anomalies were noted on a computed tomography angiogram of the chest performed for a history of shortness of breath. The patient had been previously diagnosed with and underwent treatment for subaortic valve stenosis at ages 2 and 8. PLSVC increases the incidence of congenital heart disease.

Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported.

Absent Right Superior Vena Cava With Left Superior Vena Cava Draining to an Unroofed Coronary Sinus

We describe the case of a 1-month-old infant with a complete atrioventricular septal defect with right dominance, situs solitus, and drainage from the persistent left superior vena cava to the coronary sinus. Corrective surgery was carried out without previous cardiac catheterization. During the operation, the right superior vena cava was found to be absent. Cyanosis and head-and-neck edema were observed in the immediate postoperative period. Transthoracic echocardiography carried out after injection of a small volume of stirred saline into an epicranial vein demonstrated the presence of microbubbles in the left cardiac cavities. A second operation was performed to prevent drainage from the left superior vena cava to the left atrium (via the unroofed coronary sinus) and to insert a PTFE conduit between the innominate vein and the right atrial appendage. The outcome was excellent. In this report, the embryological, clinical, diagnostic and therapeutic characteristics of this entity are discussed.

Left Superior Vena Cava Draining into the Left Atrium, Associated with Partial Anomalous Pulmonary Venous Connection: Surgical Correction

A persistent left superior vena cava draining into the left atrium may produce a symptomatic right-to-left shunt. Although intra-atrial rerouting techniques, in patients with no connecting vein, have proved to be reliable and successful, in many cases the extracardiac repair is preferable. We report a case of a 5-month-old patient with a not connected left superior vena cava draining into the left atrium, associated with atrial septal defect and partial anomalous pulmonary venous connection. The correction has been achieved by rerouting the pulmonary venous return into the left atrium and by transposition of the left vena cava on the right appendage.

Correction of Left Superior Vena Cava Draining to the Left Atrium Using Extracardiac Techniques

Intraatrial rerouting techniques have been the most common approaches to correcting left superior vena caval drainage to the left atrium in patients without atrial isomerism and with no connecting vein. Although these techniques have proved reliable and successful, there are cases in which extracardiac methods for managing this form of anomalous systemic drainage may be preferable. In the present report, we describe three extracardiac approaches to the correction of left superior vena cava draining to the left atrium.(Ann Thorac Surg 1997;63:1800–2)

Persistent Left Superior Vena Cava Draining into the Left Atrium

An 8-year-old male presented with persistent left superior vena cava draining into the left atrium, hemizygous continuation, double outlet right ventricle, cor triatriatum, and visceroatrial discordance. After correction of the double outlet right ventricle and cor triatriatum at the age of 5, he developed mild cyanosis due to a persistent left superior vena cava draining into the left atrium. At the age of 8, an intraatrial tunnel was successfully constructed with bovine pericardium to reroute the abnormal systemic venous flow.

Single (Left) Superior Vena Cava Draining into the Left Atrium: Surgical Repair

Anomalous drainage of a single left superior vena cava into the left atrium is rare, and correction presents a technical problem. This report describes a patient with absent right superior vena cava, a persistent large left superior vena cava draining to the left atrium, and an intact interatrial septum. Surgical correction was accomplished by removing the entire septum and placing a cloth baffle to cover the orifices of the pulmonary veins and mitral valve, thus partitioning pulmonary venous blood into the left ventricle. This technique of septal excision and replacement is applicable to other complicated anomalies involving the systemic and pulmonary venous channels and their relationship to the two atria. The surgical management of related anomalies of the superior vena cava is also discussed.

The Surgical Management of Persistent Left Superior Vena Cava Draining into the Left Atrium1

Persistence of a left superior vena cava with unroofing of the coronary sinus appears to be due to a single developmental complex. The functional effect is a left‐to‐right transatrial shunt associated with systemic arterial desaturation. Three cases treated surgically at the Royal Children's Hospital are reported. A well‐developed innominate vein allowed simple ligation of the persistent left superior vena cava and closure of the septal defect in one, but the other two required insertion of an intraatrial baffle in such a manner as to redirect the venous return to the right atrium.

Persistent Left Superior Vena Cava Draining into the Left Atrium with Absent Right Superior Vena Cava

A 5½-year-old boy with a persistent left superior vena cava entering the left atrium first presented with a cerebral abscess. The right superior vena cava was absent, and no other intracardiac anomalies were present. One year after drainage of the abscess, the cardiovascular anomaly was Corrected by placement of a Dacron baffle within the left atrial cavity in a manner which excluded the left superior vena caval blood flow from the left atrium and directed it into the right atrium. Although the initial repair did not hold up, after a second one the patient did well and had no further symptoms. Repair of this cardiovascular anomaly is best carried out by placement of an intraatrial baffle.