Figure 2 - uploaded by Sirin Mneimneh
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Developmental anatomy of the persistent left superior vena cava as viewed from the posterior aspect of the heart. A: Pairs of anterior and posterior cardinal veins draining into the embryonic heart via the right and left common cardinal veins. B: Development of bridging innominate vein connecting left and right anterior cardinal veins during 8th week of gestation. C: Regression of the right-sided superior vena cava with persistence of left-sided superior vena cava as a single superior vena cava that drains the cephalic portion of the body including upper extremities. D: Right-sided superior vena cava connected with the persistent left superior vena cava via innominate vein in the post-natal heart. Abbreviations: CS: coronary sinus, LACV: left anterior cardinal vein, LCCV: left common cardinal vein, LPCV: left posterior cardinal vein, LSVC: left superior vena cava, RACV: right anterior cardinal vein, RCCV: right common cardinal vein, RPCV: right posterior cardinal vein, RSVC: right superior vena cava.
Context in source publication
Context 1
... and represents the persistence of the left anterior cardinal vein 6 that continues into the left sinus horn (left duct of Cuvier) during the early developmental period. Figure 2 is a schematic representation of the developmental anatomy of the heart. In the most common form of PLSVC, both the left and right SVCs are present. ...
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... Transthoracic echocardiography can also be a useful tool, sometimes identifying an enlarged coronary sinus [3] . Computed tomography, especially with intravenous contrast, is the best method for visualization, allowing a detailed assessment of the thoracic vasculature and confirmation [4] of the exact location of the CVC tip as shown in this case (Fig. 2). ...
Introduction:
Persistence of the left superior vena cava (LSVC) is a rare anatomical variant in the general population, with an estimated incidence of 0.3-0.5% in healthy individuals. It may be diagnosed incidentally after imaging control of the placement of a central venous catheter (CVC) or other device.
Patient and methods:
We present the case of a patient with acute disease who required central venous catheterization for the administration of intravenous chemotherapy.
Results:
Central venous catheterization proved difficult and imaging control revealed the catheter tip in an unusual position. Computed tomography to verify the catheter tip position revealed the presence of a persistent left superior vena cava. The patient then underwent the planned treatment with no complications associated with the CVC.
Conclusion:
Although uncommon, persistence of the LSVC can have a significant impact in clinical practice, particularly when invasive procedures are required. Its recognition is important in order to minimize the potential complications inherent to such procedures.
Learning points:
Persistence of the left superior vena cava is an uncommon anatomical variant of the central venous vascular anatomy.It is generally asymptomatic, and its diagnosis is often incidentally made after certain procedures (central venous catheterization).Diagnosis through chest x-ray alone is difficult and should be complemented with transthoracic echocardiography and computed tomography in order to minimize the complications inherent to central venous catheterization.
Persistent left superior vena cava (PLSVC) is a rare congenital anomaly characterised by the presence of a persistent left-sided SVC in addition to the normal right-sided SVC. This case report presents a unique instance of PLSVC in a 13-year-old male patient who was incidentally diagnosed during routine cardiac imaging for an unrelated condition. The diagnostic journey, including imaging modalities such as echocardiography and computed tomography, revealed the presence of this anatomical variation. Despite being asymptomatic, the case highlights the importance of recognising PLSVC, as it can have clinical implications in various medical and surgical scenarios, particularly in cardiac catheterization, pacemaker implantation, and central venous access procedures. This report discusses the clinical significance, diagnostic challenges, and management considerations associated with PLSVC, emphasising the need for increased awareness among healthcare professionals to ensure safe and effective patient care.
