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de Beaufort CMC, Mackay TM, Stevens MF, Polderman JAW, de Jong JR, van der Hulst AE, Straver B, Gorter RR. Congenital Heart Defects in Patients with Anorectal Malformations: A Retrospective Cohort Study of 281 Patients. Pediatr Cardiol 2024:10.1007/s00246-024-03536-3. [PMID: 38836880 DOI: 10.1007/s00246-024-03536-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
In patients born with anorectal malformations (ARM), additional congenital heart defects (CHD) can occur. We aimed to provide an overview on disease and treatment details of CHD identified in patients born with ARM, from a unique large cohort of a very rare disease. We performed a retrospective single-center cohort study between January 2000 and July 2023. All consecutive patients with ARM were included. Outcomes were the number of patients with CHD, and screening percentage and percentage of patients diagnosed with CHD over 3 time periods (2000-2006, 2007-2014, 2015-2023). We used uni- and multi-variable logistic regression analyses to search for associations between CHD present and baseline characteristics. In total, 281 patients were included. Some 241 (85.8%) underwent echocardiography, of whom 80 (33.2%) had CHD. Screening percentage with echocardiography increased (74.1% vs. 85.7% vs. 95.9%, p < 0.001) and percentage of patients diagnosed with CHD remained similar over time (30.2% vs. 34.5% vs. 34.0%, p = 0.836). Atrial and ventricular septal defects (n = 36, n = 29), and persistent left superior vena cava (n = 17) were most identified. The presence of VACTERL-association or a genetic syndrome was independently associated with the presence of CHD. CHD were present in 33% of patients with ARM that underwent echocardiography. Over time, the number of CHD identified through screening remained similar. Patients with the presence of VACTERL-association or a genetic syndrome had a higher risk of having CHD. Therefore, acknowledging the potential presence of CHD in patients with ARM remains important.
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Affiliation(s)
- Cunera M C de Beaufort
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands.
| | - Tara M Mackay
- Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Markus F Stevens
- Department of Anesthesiology, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jorinde A W Polderman
- Department of Anesthesiology, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Justin R de Jong
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Annelies E van der Hulst
- Department of Pediatric Cardiology, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Bart Straver
- Department of Pediatric Cardiology, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Ramon R Gorter
- Department of Pediatric Surgery, Emma Children's Hospital Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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2
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Smolarek D, Jankowska H, Dorniak K, Hellmann M. A rare case of isolated persistent left superior vena cava diagnosed by echocardiography. J Cardiothorac Surg 2024; 19:175. [PMID: 38575998 PMCID: PMC10996098 DOI: 10.1186/s13019-024-02709-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/29/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND The persistent left superior vena cava (PLSVC) is an infrequent vascular variant. PLSVC with absent right superior vena cava, also known as isolated PLSVC, is an exceptionally rare entity. In this case we present a patient with isolated PLSVC draining to coronary sinus, diagnosed incidentally during echocardiography. CASE PRESENTATION A 35-year-old man underwent a transthoracic echocardiography which showed an enormously dilated coronary sinus. Hand-agitated saline was injected via peripheral intravenous cannulas. The contrast appeared firstly in the coronary sinus before it opacified the right atrium. Since this was also visible by the right antecubital saline injection, it indicated an extremely rare case of PLSVC with the absence of right superior vena cava which was confirmed by cardiac magnetic resonance. CONCLUSIONS The finding of a distinctively dilated coronary sinus in echocardiography led us to further investigation using agitated saline that revealed an infrequent anomaly termed isolated PLSVC. The in-depth diagnosis of this vascular variant is crucial considering that it may lead to important clinical implications, such as difficulties with central venous access, especially in the current era of a rapid development of cardiac device therapies.
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Affiliation(s)
- Dorota Smolarek
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland.
| | - Hanna Jankowska
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland
| | - Karolina Dorniak
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland
| | - Marcin Hellmann
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, Gdansk, 80-214, Poland
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Pecoraro L, Boninsegna E, Simonini E, Francia P, Colopi S, Pietrobelli A. Unexplained Hypoxemia in School-Age Child: Do Not Forget the Double Superior Vena Cava. CHILDREN 2022; 9:children9091272. [PMID: 36138581 PMCID: PMC9497274 DOI: 10.3390/children9091272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022]
Abstract
Persistent left superior vena cava (SVC) is a rare congenital malformation of the thoracic venous system. We report a case involving a 7-year-old boy, who was admitted to our CT scanning room because of an incidental discovery of low blood-oxygen levels (90–94% in good health). A persistent left SVC was depicted, with drainage in the left atrium and a resultant right-to-left shunt;right SVC was present, draining to the right atrium. A small bridging vein was depicted. A comprehensive cardiological assessment with echocardiography was performed, but no other anomalies were found. He was successfully treated with a percutaneous endovascular approach and vascular plug deployment. A complete occlusion of the left SVC was obtained, with normalization of the oxygen saturation. Persistent left SVC is a rare vascular anomaly, often incidentally detected. Physicians should be aware because it may have significant clinical implications, especially during catheterization procedures or when associated with other cardiac malformations.
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Affiliation(s)
- Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, Italy
- Department of Medicine, University of Verona, 37129 Verona, Italy
| | - Enrico Boninsegna
- Department of Radiology, Azienda Socio Sanitaria Territoriale di Mantova, 46100 Mantova, Italy
- Correspondence: ; Tel.: +39-0376201821
| | - Emilio Simonini
- Department of Radiology, Azienda Socio Sanitaria Territoriale di Mantova, 46100 Mantova, Italy
| | - Paolo Francia
- Department of Radiology, Azienda Socio Sanitaria Territoriale di Mantova, 46100 Mantova, Italy
| | - Stefano Colopi
- Department of Radiology, Azienda Socio Sanitaria Territoriale di Mantova, 46100 Mantova, Italy
| | - Angelo Pietrobelli
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, Italy
- Pennington Biomedical Research Centre, Baton Rouge, LA 70808, USA
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4
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Wójtowicz A, Madetko-Talowska A, Wójtowicz W, Szewczyk K, Huras H, Bik-Multanowski M. Cardiovascular Anomalies among 1005 Fetuses Referred to Invasive Prenatal Testing-A Comprehensive Cohort Study of Associated Chromosomal Aberrations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10019. [PMID: 36011653 PMCID: PMC9408756 DOI: 10.3390/ijerph191610019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/06/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
This retrospective cohort study comprehensively evaluates cardiovascular anomalies (CVAs) and associated extracardiac structural malformations (ECMs) among 1005 fetuses undergoing invasive prenatal testing at a single tertiary Polish center in the context of chromosomal aberrations detected in them by array comparative genomic hybridization (aCGH) and G-band karyotyping. The results of our study show that CVAs are among the most common malformations detected in fetuses undergoing invasive prenatal testing, as they affected 20% of all cases seen in our department. Septal defects predominated among fetuses with numerical aberrations, while conotruncal defects were the most common findings among fetuses with pathogenic copy number variants (CNVs). In 61% of cases, CVAs were associated with ECMs (the diagnosis was confirmed postnatally or in cases of pregnancy termination by means of autopsy). The most common ECMs were anomalies of the face and neck, followed by skeletal defects. In total, pathogenic chromosomal aberrations were found in 47.5% of CVAs cases, including 38.6% with numerical chromosomal aberrations. Pathogenic CNVs accounted for 14.5% of cases with CVAs and normal karyotype. Thus, our study highlights the importance of assessing the anatomy of the fetus, and of the genetic testing (preferably aCGH) that should be offered in all CVA and ECM cases.
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Affiliation(s)
- Anna Wójtowicz
- Department of Obstetrics & Perinatology, Jagiellonian University Medical College, 31-501 Kraków, Poland
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Jagiellonian University Medical College, 30-663 Kraków, Poland
| | - Wojciech Wójtowicz
- Information Technology Systems Department, Faculty of Management and Social Communication, Jagiellonian University, 30-348 Kraków, Poland
| | - Katarzyna Szewczyk
- Department of Medical Genetics, Jagiellonian University Medical College, 30-663 Kraków, Poland
| | - Hubert Huras
- Department of Obstetrics & Perinatology, Jagiellonian University Medical College, 31-501 Kraków, Poland
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Keleş A, Yılmaz O, Dağdeviren G, Çelik ÖY, Yücel A, Şahin D. Persistent Left Superior Vena Cava: Why is Prenatal Diagnosis Important? Fetal Pediatr Pathol 2022; 41:592-602. [PMID: 34106033 DOI: 10.1080/15513815.2021.1933662] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
ObjectiveTo investigate fetal anomalies and pregnancy outcomes in pregnancies with persistent left superior vena cava (PLSVC) to provide assistance in prenatal counseling.MethodsCases diagnosed with PLSVC between January 2015 and January 2020 were obtained from the hospital's electronic system and were analyzed retrospectively.ResultsTwenty-seven cases were analyzed. The prevalence of PLSVC among congenital heart diseases (CHD) was 6.9%. Conotruncal anomalies and renal anomalies were the most common accompanying cardiac and extracardiac anomalies, respectively. Chromosomal abnormality was detected in one fetus.In the postpartum period coarctation of aorta (CoA) was found in one fetus.ConclusionsWhen PLSVC is detected during prenatal ultrasonography, fetal anatomy should be carefully examined because of the anomalies that may accompany it. Prenatal genetic counseling should be given especially to cases with additional anomalies. In isolated cases, cardiac anatomy should be evaluated with repeated echocardiography because of the risk of CoA.
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Affiliation(s)
- Ayşe Keleş
- Perinatology Department, University of Health Sciences Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Osman Yılmaz
- Pediatric Cardiology Department, University of Health Sciences Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Gülşah Dağdeviren
- Perinatology Department, University of Health Sciences Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Özge Yücel Çelik
- Perinatology Department, University of Health Sciences Etlik Zübeyde Hanım Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Aykan Yücel
- Perinatology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Perinatology Department, Ministry of Health Ankara City Hospital, Ankara, Turkey
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Kantenwein V, Telishevska M, Bourier F, Kottmaier M, Brkic A, Risse E, Popa M, Lengauer S, Kolb C, Deisenhofer I, Hessling G, Reents T. Feasibility and safety of left atrial access for ablation of atrial fibrillation in patients with persistent left superior vena cava. Pacing Clin Electrophysiol 2022; 45:357-364. [PMID: 35015906 DOI: 10.1111/pace.14446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/02/2021] [Accepted: 01/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND In patients with persistent left superior vena cava (PLSVC) ablation procedures can be challenging. We sought to determine the feasibility and safety of left atrial ablations in patients with PLSVC, especially when PLSVC is unknown prior to the ablation procedure. METHODS AND RESULTS In this retrospective analysis 15 adult patients (mean age 64.6 ± 14.5 years, 53.3% male) with PLSVC undergoing 27 ablation procedures for atrial fibrillation or left atrial flutter were included. In 5 (33,3%) patients PLSVC was only discovered during the procedure. Transseptal puncture (TSP) was declared "difficult" by the ablating physician in 13 of 27 (48,2%) procedures and was not successfully completed in the first attempt in two patients with known PLSVC. Once TSP was successfully completed, all relevant structures were reached both during mapping and ablation in all procedures independent of whether PLSVC was known prior to the procedure. One major complication (3,7%) occurred in 27 procedures in a patient with known PLSVC. In the patients with unknown PLSVC no complication occurred. CONCLUSION In experienced hands, left atrial access and ablation in patients with PLSVC is feasible and safe, particularly with regard to patients in whom the PLSVC is unknown prior to the ablation procedure. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Verena Kantenwein
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Marta Telishevska
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Felix Bourier
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Marc Kottmaier
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Amir Brkic
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Elena Risse
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Miruna Popa
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Sarah Lengauer
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Christof Kolb
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Isabel Deisenhofer
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Gabriele Hessling
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
| | - Tilko Reents
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung Elektrophysiologie, Technische Universität München, Munich, Germany
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7
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Aihole JS. Persistent Left Superior Vena Cava: A Rare Association. Glob Pediatr Health 2021; 8:2333794X211015527. [PMID: 34104691 PMCID: PMC8150421 DOI: 10.1177/2333794x211015527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Persistent left superior vena cava (PLSVC) is the most frequent abnormality in the general population with the frequency of 0.1% to 0.5%. It results from the failure of the involution of the left anterior cardinal vein. Right and Left SVC can coexist together in 80% to 90% of cases. Association of PLSVC with ano rectal malformation (ARM) is very rarely reported. Hence, here is a report of a unique case of PLSVC in a female neonate with ARM.
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Lai ST, Chen CP, Lin CJ, Chen SW, Town DD, Wang W. Prenatal diagnosis of persistent left superior vena cava, polyhydramnios and a small gastric bubble in a fetus with VACTERL association. Taiwan J Obstet Gynecol 2021; 60:355-358. [PMID: 33678342 DOI: 10.1016/j.tjog.2021.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE We reported a fetus that presenting with persistent left superior vena cava (PLSVC), polyhydramnios, and a small gastric bubble during prenatal examination and identified VACTERL association after birth. CASE REPORT A 34-year-old woman underwent amniocentesis at 18 weeks of gestation because of advanced maternal age and the result was normal. Subsequently, an ultrasound revealed single umbilical artery (SUA) at 21 weeks of gestation. She received a detailed fetal anatomy survey that presented the same findings and PLSVC. A small visible gastric bubble was noted at that time, and the other organs were unremarkable. Polyhydramnios was identified at 30 weeks of gestation and amnioreduction was subsequently performed at 32 weeks of gestation. However, polyhydramnios was persisted despite amnioreduction and intrauterine growth restriction was also detected. A cesarean section was performed because of fetal distress at 36 + 2 weeks, and a 1832-g female baby was delivered. Pre-axial polydactyly at left thumb, SUA and esophageal atresia with distal tracheoesophageal fistula (TEF) were identified after birth. The neonate died at age of 4 days because of surgical complication following esophageal anastomosis. CONCLUSION Prenatal diagnosis of PLSVC associated with polyhydramnios and a small gastric bubble may indicate esophageal atresia with TEF, and further examination for associated syndromes such as VACTERL association is warranted.
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Affiliation(s)
- Shih-Ting Lai
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Chen-Ju Lin
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Dai-Dyi Town
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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Savu C, Petreanu C, Melinte A, Posea R, Balescu I, Iliescu L, Diaconu C, Galie N, Bacalbasa N. Persistent Left Superior Vena Cava - Accidental Finding. In Vivo 2020; 34:935-941. [PMID: 32111807 DOI: 10.21873/invivo.11861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/05/2020] [Accepted: 01/07/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND/AIM The presence of the superior left vena cava represents a rare anomaly of the thoracic venous system. CASE REPORT An asymptomatic case of this type of anomaly, discovered as an accident during investigations for a different pathology (superior left pulmonary lobe tumor), is presented. A 56-year-old, heavy smoker was admitted in our clinic with a tumoral mass in the left superior pulmonary lobe discovered during a routine chest x-ray. Physical and clinical examination was normal. However, transthoracic echography noted a coronary sinus enlargement, which led to the suspicion of a thoracic venous anomaly. Contrast chest computed tomography pointed out a venous anomaly at the level of the left hemithorax originating from the cervical region, crossing the aortic arch and draining in the coronary sinus. During the examination, contrast substance was not detected in the right superior vena cava, either early or late during the computed tomography. During surgery the presence of a persistent left superior vena cava was observed, coming from the cervical region, crossing lateral to the aortic arch and draining in the coronary sinus. CONCLUSION The presence of an enlarged coronary sinus should warn the surgeon about the possibility of a thoracic venous anomaly. Identifying a persistent left superior vena cava is important due to its clinical implications, especially during certain procedures such as mounting central venous lines, cardiac cannulation or implantation of cardiac stimulators.
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Affiliation(s)
- Cornel Savu
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumophthisiology, Bucharest, Romania.,Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Cornel Petreanu
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumophthisiology, Bucharest, Romania.,Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexandru Melinte
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumophthisiology, Bucharest, Romania
| | - Radu Posea
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumophthisiology, Bucharest, Romania
| | - Irina Balescu
- Department of Visceral Surgery, "Ponderas Academic Hospital", Bucharest, Romania
| | - Laura Iliescu
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine, "Fundeni" Clinical Institute, Bucharest, Romania
| | - Camelia Diaconu
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine, "Floreasca" Emergency Clinical Hospital, Bucharest, Romania
| | - Nicolae Galie
- Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumophthisiology, Bucharest, Romania.,Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Nicolae Bacalbasa
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Department of Visceral Surgery, Center of Excellence in Translational Medicine, "Fundeni" Clinical Institute, Bucharest, Romania.,Department of Obstetrics and Gynecology, "I. Cantacuzino" Clinical Hospital, Bucharest, Romania
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10
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Azizova A, Onder O, Arslan S, Ardali S, Hazirolan T. Persistent left superior vena cava: clinical importance and differential diagnoses. Insights Imaging 2020; 11:110. [PMID: 33057803 PMCID: PMC7561662 DOI: 10.1186/s13244-020-00906-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/20/2020] [Indexed: 01/07/2023] Open
Abstract
Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly and may be a component of the complex cardiac pathologies. While it is often asymptomatic, it can lead to significant problems such as arrhythmias and cyanosis. Besides, it can cause serious complications during vascular interventional procedures or the surgical treatment of cardiac anomalies (CA). The clinical significance of PLSVC depends on the drainage site and the accompanying CA. In this article, we will describe the epidemiology, embryology, and anatomic variations of PLSVC. Possible accompanying CA and heterotaxy spectrum will be reviewed with the help of multidetector computed tomography (MDCT) images. Radiological pitfalls, differential diagnoses, and the clinical importance of PLSVC will be highlighted.
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Affiliation(s)
- Aynur Azizova
- grid.14442.370000 0001 2342 7339Department of Radiology, Hacettepe University School of Medicine, 06100 Ankara, Turkey
| | - Omer Onder
- grid.14442.370000 0001 2342 7339Department of Radiology, Hacettepe University School of Medicine, 06100 Ankara, Turkey
| | - Sevtap Arslan
- grid.14442.370000 0001 2342 7339Department of Radiology, Hacettepe University School of Medicine, 06100 Ankara, Turkey
| | - Selin Ardali
- grid.14442.370000 0001 2342 7339Department of Radiology, Hacettepe University School of Medicine, 06100 Ankara, Turkey
| | - Tuncay Hazirolan
- grid.14442.370000 0001 2342 7339Department of Radiology, Hacettepe University School of Medicine, 06100 Ankara, Turkey
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11
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Via Reque Cortes DDP, Andrade Vale P, Gessolo Lins PR. Unusual Dialysis Catheter Location in a Transplant Patient. KIDNEY360 2020; 1:884-886. [PMID: 35372953 PMCID: PMC8815739 DOI: 10.34067/kid.0001252020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/31/2020] [Indexed: 06/14/2023]
Affiliation(s)
| | - Pablo Andrade Vale
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Chowdhury UK, Anderson RH, George N, Singh S, Sankhyan LK, Gayatri SB, Malik V, Gharde P, Sengupta S. A Review of the Surgical Management of Anomalous Connection of the Right Superior Caval Vein to the Morphologically Left Atrium and Biatrial Drainage of Right Superior Caval Vein. World J Pediatr Congenit Heart Surg 2020; 11:466-484. [PMID: 32645787 DOI: 10.1177/2150135120912677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present perspective is a synthesis of published investigations in the setting of anomalous connection of the right superior caval vein to the morphologically left atrium or biatrial drainage of the right caval vein. We identified 57 suitable cases from 97 investigations, reviewing the clinical presentation, diagnostic modalities utilized, surgical techniques used, and their outcomes. Clinical presentation, radiographic findings, saline contrast echocardiography, computed tomographic angiocardiography, radionuclide perfusion scan, magnetic resonance imaging, and angiocardiography provided the diagnostic information and were used to define the disease entities before surgery. We have also addressed several issues concerning the influence of the so-called heterotaxy: the establishment of the diagnosis, the variation in clinical presentation, and subsequent management. For the overall group of patients undergoing either surgical intervention or transcatheter treatment with an Amplatzer vascular plug, the operative mortality remains high at 9.5%. We submit that an increased appreciation of these disease entities will contribute to improved future surgical management.
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Affiliation(s)
- Ujjwal Kumar Chowdhury
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Robert H Anderson
- Biosciences Institute, Newcastle University. Newcastle upon Tyne, United Kingdom
| | - Niwin George
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sukhjeet Singh
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Lakshmi Kumari Sankhyan
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sushama B Gayatri
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwas Malik
- Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - Parag Gharde
- Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjoy Sengupta
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
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Elhamamsy M, Aldemerdash A, Zahran F, Bakir BM, Alanazi NA, Awadallah YA, Haggag SI, Alshiekh MS. Persistent left superior vena cava in patient with right atrial myxoma undergoing open heart surgery. A case report and review of literature. Saudi J Anaesth 2020; 14:217-220. [PMID: 32317878 PMCID: PMC7164439 DOI: 10.4103/sja.sja_511_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 09/24/2019] [Indexed: 11/04/2022] Open
Abstract
Persistent left superior vena cava (PLSVC) is a rare and asymptomatic congenital cardiovascular anomaly. Being asymptomatic, PLSVC was usually discovered while performing interventions (such as insertion of central lines, Swan-Ganz catheters, or placing pacemakers) through the left internal jugular vein or left subclavian veins. Commonly, PLSVC is detected not only as an isolated congenital anomaly, but also it can be associated with many other cardiac anomalies. Also, presence of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by contrast venography or computed tomography angiography. The present case is a female patient, 29 year old, who was undergoing elective excision of a right atrial mass, with closure of patent foramen ovale, and she had end-stage renal failure on regular hemodialysis three times weekly through a permicath inserted in the right subclavian vein.
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Affiliation(s)
- Mostafa Elhamamsy
- Department of Cardiac Anesthesia, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - A Aldemerdash
- Department of Cardiac Anesthesia, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - F Zahran
- Department of Cardiac Anesthesia, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - B M Bakir
- Department of Cardiac Surgery, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Nouf A Alanazi
- Department of Interventional Cardiology, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Yasser Abdulrahman Awadallah
- Department of Cardiac Surgery, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Sami Ibrahim Haggag
- Department of Cardiac Surgery, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mahmoud Salama Alshiekh
- Department of Cardiac Surgery, King Fahd Cardiac Center, College of Medicine, King Saud University Medical City, Riyadh, Kingdom of Saudi Arabia
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Özsürmeli M, Büyükkurt S, Sucu M, Arslan E, Akçabay Ç, Mısırlıoğlu S, Kayapınar M, Özbarlas N, Demir SC, Evrüke C. Prenatal diagnosis of persistent left superior vena cava: a retrospective study of associated congenital anomalies. Turk J Obstet Gynecol 2019; 16:23-28. [PMID: 31019836 PMCID: PMC6463432 DOI: 10.4274/tjod.galenos.2019.02679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/06/2019] [Indexed: 12/02/2022] Open
Abstract
Objective: To evaluate persistent left superior vena cava (PLSVC) cases according to associated cardiac, extracardiac, and chromosomal anomalies in the prenatal period and to review their outcomes. Materials and Methods: The data of patients with a prenatal diagnosis of PLSVC between January 2013 and December 2017 were reviewed retrospectively. Results: Data of 32 cases were reviewed. Nineteen (60%) cases were associated with cardiac defects, 5 (15%) were associated with both cardiac and extracardiac defects, and 8 (25%) had no associated anomalies. Two fetuses had karyotype anomalies. All patients with isolated PLSVC survived. Among the cases associated with extracardiac anomalies, cardiac anomalies, and with both extracardiac and cardiac anomalies, the survival rate was 40%, 40%, and 25%, respectively. Outcome was more favorable in cases with isolated PLSVC (100% vs. 40%). Conclusion: Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. The prognosis is good in isolated cases, but worsens when accompanied by cardiac or extracardiac anomalies.
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Affiliation(s)
- Mehmet Özsürmeli
- University of Health Sciences, Derince Training and Research Hospital, Clinic of Obstetrics and Gynecology, Kocaeli, Turkey
| | - Selim Büyükkurt
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
| | - Mete Sucu
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
| | - Erol Arslan
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
| | - Çiğdem Akçabay
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
| | - Selahattin Mısırlıoğlu
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
| | - Masum Kayapınar
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
| | - Nazan Özbarlas
- Çukurova University Faculty of Medicine, Department of Pediatrics, Pediatric Cardiology Unit, Adana, Turkey
| | - Süleyman Cansun Demir
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
| | - Cüneyt Evrüke
- Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology, Perinatology Unit, Adana, Turkey
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Reyes KM, Gupta D, Fricker FJ, Cooke S, Bleiweis MS. Heart Transplant in Patient With Isolated Left Superior Vena Cava by Atrial Appendage Rotation. Ann Thorac Surg 2018; 105:e279-e281. [PMID: 29410126 DOI: 10.1016/j.athoracsur.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/26/2017] [Accepted: 01/03/2018] [Indexed: 11/28/2022]
Abstract
Orthotopic heart transplantation in patients with an isolated persistent left superior vena cava is extremely rare, and the anastomotic connection between a right-sided donor superior vena cava and left-sided recipient superior vena cava can be challenging to perform. We present a novel technique used in an infant female, using the left atrial appendage to extend the superior vena cava anastomosis.
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Affiliation(s)
- Karl M Reyes
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida.
| | - Dipankar Gupta
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
| | - Frederick Jay Fricker
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
| | - Susan Cooke
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
| | - Mark S Bleiweis
- Congenital Heart Center, Departments of Surgery and Pediatrics, University of Florida-Shands Children's Hospital, Gainesville, Florida
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Familial Screening for Left-Sided Congenital Heart Disease: What Is the Evidence? What Is the Cost? Diseases 2017; 5:diseases5040029. [PMID: 29292713 PMCID: PMC5750540 DOI: 10.3390/diseases5040029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 12/03/2017] [Accepted: 12/05/2017] [Indexed: 11/21/2022] Open
Abstract
Since the American Heart Association’s recommendation for familial screening of adults with congenital heart disease for bicuspid aortic valve, similar recommendations for other left-sided heart defects, such as hypoplastic left heart syndrome (HLHS), have been proposed. However, defining at-risk populations for these heart defects based on genetics is less straightforward due to the wide variability of inheritance patterns and non-genetic influences such as environmental and lifestyle factors. We discuss whether there is sufficient evidence to standardize echocardiographic screening for first-degree relatives of children diagnosed with HLHS. Due to variations in the inclusion of cardiac anomalies linked to HLHS and the identification of asymptomatic individuals with cardiac malformations, published studies are open to interpretation. We conclude that familial aggregation of obstructive left-sided congenital heart lesions in families with history of HLHS is not supported and recommend that additional screening should adopt a more conservative definition of what truly constitutes this heart defect. More thorough consideration is needed before embracing familial screening recommendations of families of patients with HLHS, since this could inflict serious costs on healthcare infrastructure and further burden affected families both emotionally and financially.
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Clarke NS, Murthy RA, Guleserian KJ. Persistent Left Superior Vena Cava: Incidence and Management in Patients Undergoing Repair of Partial Anomalous Pulmonary Venous Connection. World J Pediatr Congenit Heart Surg 2017; 8:440-444. [PMID: 28696881 DOI: 10.1177/2150135117708706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION A association between partial anomalous pulmonary venous connection (PAPVC) and systemic venous anomalies has been described in the literature, but the true incidence is yet to be elucidated. At our institution, we sought to find the incidence of a persistent left superior vena cava (PLSVC) in patients undergoing an operation for PAPVC. METHODS A retrospective review of all pediatric and adult patients with PAPVC who underwent surgical repair from February 2006 to February 2016. All clinical, radiographic, and operative data were reviewed. RESULTS Eighty-five patients underwent surgical repair. A PLSVC was identified in 15 (17.6%) patients. Every PLSVC drained/connected to the coronary sinus. A bridging vein was present in only 26.7% (4 of 15). Intraoperative management of the PLSVC consisted of direct cannulation in nine (60%) patients, temporary occlusion in one (6.7%) patient, and ligation in one (6.7%) patient. In the 15 PLSVC patients, 6 (40%) had a secundum atrial septal defect (ASD), 2 (13.3%) had a patent foramen ovale (PFO), 10 (66.6%) had a sinus venosus type defect, and 3 (20%) had both an ASD and sinus venosus-type defect. Of the 15 patients with PAPVC and PLSVC, 14 (93%) had anomalous drainage of pulmonary vein(s) on the right side, whereas 1 (7%) had veins on both sides with anomalous drainage. CONCLUSION Persistent left superior vena cava is present in 17.6% of patients undergoing an operation for PAPVC. Awareness of this association as well as the intraoperative management of PLSVC is advised for those that perform operations for PAPVC. As improper myocardial protection and cardiopulmonary bypass strategies in the presence of a PLSVC can result in deleterious outcomes.
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Affiliation(s)
- Nicholas S Clarke
- 1 Division of Pediatric Cardiothoracic Surgery, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, TX, USA
| | - Raghav A Murthy
- 2 Division of Pediatric Cardiothoracic Surgery, Rady Children's Hospital, San Diego, University of California, San Diego, CA, USA
| | - Kristine J Guleserian
- 3 Division of Pediatric Cardiothoracic Surgery, Nicklaus Children's Hospital, Miami, FL, USA
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Jazayeri MA, Karim R. What's in a Name? Utilization of the Innominate Vein for Pacemaker Lead Placement in the Setting of Persistent Left Superior Vena Cava. Cureus 2017; 9:e1057. [PMID: 28367394 PMCID: PMC5364088 DOI: 10.7759/cureus.1057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Persistent left superior vena cava (PLSVC) represents the most common thoracic venous anomaly and is an important clinical entity for cardiologists and electrophysiologists, among others. In approximately 30% of cases, a bridging innominate vein connects the left superior vena cava to the right. The present report highlights the value of defining the venous anatomy with a case of dual-chamber pacemaker implantation in the PLSVC with the right ventricular lead placed via the innominate vein. Pertinent considerations for device implantation in the setting of this anomaly are discussed and relevant venography reviewed.
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Affiliation(s)
| | - Rehan Karim
- Division of Cardiology, Hennepin County Medical Center, University of Minnesota Medical School
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19
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Opotowsky AR, Webb GD. Evolving Understanding of Shone Complex Through the Lifespan: What's in an Eponym? Can J Cardiol 2017; 33:214-215. [DOI: 10.1016/j.cjca.2016.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 11/24/2016] [Accepted: 11/24/2016] [Indexed: 12/14/2022] Open
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Ari ME, Doğan V, Özgür S, Ceylan Ö, Ertuğrul İ, Kayalı Ş, Yoldaş T, Örün UA, Kaya Ö, Karademir S. Persistent left superior vena cava accompanying congenital heart disease in children: Experience of a tertiary care center. Echocardiography 2017; 34:436-440. [PMID: 28052532 DOI: 10.1111/echo.13447] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study focuses on determining concomitant persistent left superior vena cava (SVC) in patients with congenital heart disease (CHD). METHODS Between 2005 and 2012, a total of 2.663 patients with CHD, 88 (3.3%) of whom were diagnosed with persistent left SVC, were evaluated retrospectively. The demographic characteristics of patients, clinical and radiographic findings, echocardiography, cardiac catheterization, and angiography results obtained from the patients' records were reviewed. RESULTS The median age of the patients was 9.5 months, and 46 of the 88 (52.3%) patients were female. The most common concomitant CHD were ventricular septal defect, double outlet right ventricle (DORV), and tetralogy of Fallot (TOF). When the patients were compared according to their CHD, persistent left SVC frequency was significantly higher in those with DORV (P<.001), TOF (P=.04), patent ductus arteriosus (P=.01), and atrial septal defect (P=.03). Eighty-three of the 88 (94.3%) patients with persistent left SVC had right SVC, and 5 (5.7%) had absence of the right SVC. Twenty-seven of the 83 (32.5%) patients with double SVC had connected normal innominate vein. In all cases, right aortic arch association was seen in 14 (15.9%) patients. Eighty-four (95.4%) of the patients were diagnosed by echocardiography prior to catheter angiography. Persistent left SVC drained to the coronary sinus in all cases. CONCLUSION Increased awareness about the association of certain CHD with persistent left SVC and a careful echocardiographic examination can facilitate the diagnosis of persistent left SVC. In addition, precise prior diagnosis of persistent left SVC can prevent complications during surgery.
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Affiliation(s)
- Mehmet Emre Ari
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Vehbi Doğan
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Senem Özgür
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Özben Ceylan
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - İlker Ertuğrul
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Şeyma Kayalı
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Tamer Yoldaş
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Utku Arman Örün
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Özkan Kaya
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Selmin Karademir
- Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Gustapane S, Leombroni M, Khalil A, Giacci F, Marrone L, Bascietto F, Rizzo G, Acharya G, Liberati M, D'Antonio F. Systematic review and meta-analysis of persistent left superior vena cava on prenatal ultrasound: associated anomalies, diagnostic accuracy and postnatal outcome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2016; 48:701-708. [PMID: 26970258 DOI: 10.1002/uog.15914] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/29/2016] [Accepted: 03/05/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To quantify the prevalence of chromosomal anomalies in fetuses with persistent left superior vena cava (PLSVC), assess the strength of the association between PLSVC and coarctation of the aorta and ascertain the diagnostic accuracy of antenatal ultrasound in correctly identifying isolated cases of PLSVC. METHODS MEDLINE, EMBASE, CINHAL and the Cochrane databases were searched from the year 2000 onwards using combinations of keywords 'left superior vena cava' and 'outcome'. Two authors reviewed all abstracts independently. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. The rates of the following outcomes were analyzed: chromosomal abnormalities; associated intracardiac anomalies (ICAs) and extracardiac anomalies (ECAs) diagnosed prenatally; additional ICAs and ECAs detected only at postnatal imaging or clinical evaluation but missed at prenatal imaging; and association of PLSVC and coarctation of the aorta. Meta-analyses of proportions were used to combine data. RESULTS In total, 2708 articles were identified and 13 (n = 501) were included in the systematic review. Associated ICAs and ECAs were detected at the prenatal ultrasound examination or at a follow-up assessment in 60.7% (95% CI, 44.2-75.9%) and 37.8% (95% CI, 31.0-44.8%) of cases, respectively. Chromosomal anomalies occurred in 12.5% (95% CI, 9.0-16.4%) of cases in the overall population of fetuses with PLSVC and in 7.0% (95% CI, 2.7-13.0%) of isolated cases. Additional ICAs and ECAs were detected only after birth and missed at ultrasound in 2.4% (95% CI, 0.5-5.8%) and 6.7% (95% CI, 2.2-13.2%) of cases, respectively. Coarctation of the aorta was associated with isolated PLSVC in 21.3% (95% CI, 13.6-30.3%) of cases. CONCLUSIONS PLSVC is commonly associated with ICAs, ECAs and chromosomal anomalies. Fetuses with isolated PLSVC should be followed up throughout pregnancy in order to rule out coarctation of the aorta. As most of the data in this review were derived from high-risk pregnancies, the rate of associated abnormalities is likely to be higher than that in the general population of fetuses with PLSVC, for which more data are needed. Revisión sistemática y metaanálisis de la persistencia de la vena cava superior izquierda en la ecografía prenatal: anomalías asociadas, precisión del diagnóstico y resultado postnatal RESUMEN OBJETIVOS: Cuantificar la prevalencia de anomalías cromosómicas en fetos con vena cava superior izquierda persistente (VCSIP), evaluar la solidez de la asociación entre la VCSIP y la coartación aórtica, y determinar la precisión del diagnóstico de la ecografía prenatal como método para identificar correctamente casos aislados de VCSIP. MÉTODOS: Se buscó en las bases de datos de MEDLINE, EMBASE, CINHAL y Cochrane artículos publicados desde el año 2000 en adelante, usando combinaciones de las palabras clave "vena cava superior izquierda" y "resultado". Dos de los autores revisaron de forma independiente todos los resúmenes encontrados. La evaluación de calidad de los estudios incluidos se realizó mediante la escala Newcastle-Ottawa para estudios de cohortes. Se analizaron las tasas de los siguientes resultados: anomalías cromosómicas; anomalías intracardíacas (AIC) y anomalías extracardíacas (AEC) asociadas diagnosticadas prenatalmente; AIC y AEC adicionales detectadas sólo en ecografías postnatales o mediante evaluación clínica, pero no observadas en ecografías prenatales; y la asociación entre la VCSIP y la coartación aórtica. Se utilizó un meta-análisis de proporciones para combinar los datos. RESULTADOS En total, se identificaron 2708 artículos y se incluyeron 13 (n = 501) en la revisión sistemática. En la ecografía prenatal o en una revisión de seguimiento se detectaron AIC y AEC asociadas en el 60,7% (IC 95%, 44,2-75,9%) y el 37,8% (IC 95%, 31,0-44,8%) de los casos, respectivamente. Se produjeron anomalías cromosómicas en el 12,5% (IC 95%, 9,0-16,4%) de los casos en la población general de fetos con VCSIP y en el 7,0% (IC 95%, 2,7-13,0%) de casos aislados. Las AIC y AEC adicionales sólo se detectaron después del nacimiento y en el 6,7% (IC 95%, 2,2-13,2%) de los casos, respectivamente. La coartación aórtica se encontró asociada con la VCSIP aislada en un 21,3% (IC 95%, 13,6-30,3%) de los casos. CONCLUSIONES La VCSIP está comúnmente asociada a AIC, AEC y anomalías cromosómicas. Los fetos con VCSIP aislada deben ser objeto de seguimiento durante todo el embarazo, con el fin de descartar la coartación aórtica. Como la mayoría de los datos de esta revisión proceden de embarazos de alto riesgo, es probable que la tasa de anomalías asociadas sea más alta que la de la población general de fetos con VCSIP, por lo que se necesitan más datos.
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Affiliation(s)
- S Gustapane
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - M Leombroni
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - A Khalil
- Fetal Medicine Unit, Division of Developmental Sciences, St George's University of London, London, UK
| | - F Giacci
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - L Marrone
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - F Bascietto
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - G Rizzo
- Department of Obstetrics and Gynecology, Università di Roma, Rome, Italy
| | - G Acharya
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway
| | - M Liberati
- Department of Obstetrics and Gynaecology, SS. Annunziata Hospital, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - F D'Antonio
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of Northern Norway, Tromsø, Norway
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Liu X, He Y, Tian Z, Rychik J. Persistent Left Superior Vena Cava Connected to the Coronary Sinus in the Fetus: Effects on Cardiac Structure and Flow Dynamics. Pediatr Cardiol 2016; 37:1085-90. [PMID: 27084383 DOI: 10.1007/s00246-016-1395-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/05/2016] [Indexed: 11/26/2022]
Abstract
Ventricular size discrepancy may be due to a persistent left superior vena cava (PLSVC) in utero. We sought to investigate for differences in cardiac structure measures and hemodynamics between fetuses with isolated PLSVC connected to the coronary sinus (CS) and normal. Fetuses diagnosed with isolated PLSVC in the second and third trimester were enrolled. We defined two groups: group 1, twenty-five fetuses in the second trimester (22-27 W + 6d); group 2, twenty-two fetuses in the third trimester (28-39 W + 6d). Fifty-three fetuses without intra-cardiac or extra-cardiac anomalies and gestation age-matched were divided into normal control groups: group 3, 28 fetuses in the second trimester; group 4, 25 fetuses in the third trimester. Parameters of cardiac structure and hemodynamics were measured, including: left- and right-side heart size, the diameter of foramen ovale, aorta (AO), aortic isthmus and pulmonary artery (PA), and ratios of cardiac structure RV/LV, RA/LA and PA/AO were calculated. Hemodynamic parameters measured included: flow velocity across mitral valve, tricuspid valve and foramen ovale. In the second trimester, the ratio of RV/LV and PA/AO of the PLSVC fetuses was significantly larger than normal, while the AO diameter, aortic isthmus diameter were smaller than normal (P < 0.05). However, in the third trimester, only the ratio of PA/AO of the PLSVC fetuses was significantly larger, and the aortic isthmus diameter was still smaller than normal (P < 0.05). Isolated PLSVC connecting to the CS is associated with differences in cardiac structure size from normal. These differences appear to diminish with gestational age. A dilated CS may have an influence on development of fetal left heart structures.
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Affiliation(s)
- Xiaowei Liu
- Fetal Heart Disease Maternal Fetal Medicine Research Laboratories, Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China
| | - Yihua He
- Fetal Heart Disease Maternal Fetal Medicine Research Laboratories, Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, 100029, Beijing, China.
| | - Zhiyun Tian
- Fetal Heart Program, The Cardiac Center at The Children's Hospital of Philadelphia, 34th St. and Civic Center Blvd., Philadelphia, PA, 19104-4399, USA
| | - Jack Rychik
- Fetal Heart Program, The Cardiac Center at The Children's Hospital of Philadelphia, 34th St. and Civic Center Blvd., Philadelphia, PA, 19104-4399, USA
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Razi M, Madaan A, Goel A, Sinha SK. Troubleshooting during pacemaker implant in persistent left superior vena cava with absence of right superior vena cava (isolated persistent left superior vena cava). Avicenna J Med 2016; 6:47-50. [PMID: 27144141 PMCID: PMC4849188 DOI: 10.4103/2231-0770.179550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Persistent left superior vena cava (PLSVC) with absence of right SVC (isolated PLSVC) is a rare congenital anomaly that occurs as a result of a degenerative condition in the left anterior cardinal vein. It is generally an incidental finding while performing invasive procedures such as antiarrhythmic device implantation. We report on a rare case of permanent pacemaker implantation in a patient with this anomaly from right subclavian route, albeit most of the earlier reported cases are from left subclavian approach. A wide spectrum of clinicians should be aware of this anomaly, its variations, and possible complications.
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Affiliation(s)
- Mahmadulla Razi
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Amit Madaan
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Amit Goel
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Santosh Kumar Sinha
- Department of Cardiology, L.P.S. Institute of Cardiology, GSVM Medical College, Kanpur, Uttar Pradesh, India
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Steckiewicz R, Kosior DA, Rosiak M, Świętoń E, Stolarz P, Grabowski M. The prevalence of superior vena cava anomalies as detected in cardiac implantable electronic device recipients at a tertiary cardiology centre over a 12-year period. Hellenic J Cardiol 2016; 57:101-6. [DOI: 10.1016/j.hjc.2016.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 11/12/2015] [Indexed: 01/25/2023] Open
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Daruwalla VJ, Parekh K, Tahir H, Collins JD, Carr J. Raghib Syndrome Presenting as a Cryptogenic Stroke: Role of Cardiac MRI in Accurate Diagnosis. Case Rep Cardiol 2015; 2015:921247. [PMID: 26106490 PMCID: PMC4461698 DOI: 10.1155/2015/921247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 05/15/2015] [Accepted: 05/19/2015] [Indexed: 11/24/2022] Open
Abstract
Raghib Syndrome is a rare developmental complex, which consists of persistence of the left superior vena cava (PLSVC) along with coronary sinus ostial atresia and atrial septal defect. This Raghib complex anomaly has also been associated with other congenital malformations including ventricular septal defects, enlargement of the tricuspid annulus, and pulmonary stenosis. Our case demonstrates an isolated PLSVC draining into the left atrium along with coronary sinus atresia in a young patient presenting with cryptogenic stroke without the atrial septal defect. Majority of the cases reported in the literature were found to have the lesion during the postmortem evaluation or were characterized at angiography and/or echocardiography. We stress the importance of modern day imaging like the computed tomography (CT) angiography and cardiac MRI in diagnosis and surgical management of such rare lesions leading to cryptogenic strokes.
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Affiliation(s)
| | - Keyur Parekh
- Department of Cardiovascular Radiology, Northwestern University Feinberg School of Medicine, USA
| | - Hassan Tahir
- Conemaugh Memorial Hospital/Temple University, USA
| | - Jeremy D. Collins
- Department of Cardiovascular Radiology, Northwestern University Feinberg School of Medicine, USA
| | - James Carr
- Department of Cardiovascular Radiology, Northwestern University Feinberg School of Medicine, USA
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Affiliation(s)
- Abhijit S Nair
- Department of Anesthesiology and Critical Care, Citizens Hospital, Hyderabad, Telangana, India
| | - Venugopal Kulkarni
- Department of Anesthesiology and Critical Care, Citizens Hospital, Hyderabad, Telangana, India
| | - Sunjoy Verma
- Department of Anesthesiology and Critical Care, Citizens Hospital, Hyderabad, Telangana, India
| | - Ravikiran Mudunuri
- Department of Anesthesiology and Critical Care, Citizens Hospital, Hyderabad, Telangana, India
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Schweiger M, Stiasny B, Dave H, Cavigelli-Brunner A, Balmer C, Kretschmar O, Bürki C, Klauwer D, Hübler M. Pediatric heart transplantation. J Thorac Dis 2015; 7:552-9. [PMID: 25922739 DOI: 10.3978/j.issn.2072-1439.2015.01.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 11/25/2014] [Indexed: 11/14/2022]
Abstract
Pediatric heart transplantation (pHTx) represents a small (14%) but very important and particular part in the field of cardiac transplantation. This treatment has lifelong impact on children. To achieve the best short and especially long-term survival with adequate quality of life, which is of crucial importance for this young patient population, one has to realize and understand the differences with adult HTx. Indication for transplantation, waitlist management including ABO incompatible (ABOi) transplantation and immunosuppression differ. Although young transplant recipients are ultimately likely to be considered for re-transplantation. One has to distinguish between myopathy and complex congenital heart disease (CHD). The differences in anatomy and physiology make the surgical procedure much more complex and create unique challenges. These recipients need a well-organized and educated team with pediatric cardiologists and intensivists, including a high skilled surgeon, which is dedicated to pHTx. Therefore, these types of transplants are best concentrated in specialized centers to achieve promising outcome.
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Affiliation(s)
- Martin Schweiger
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Brian Stiasny
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Hitendu Dave
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Anna Cavigelli-Brunner
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Christian Balmer
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Oliver Kretschmar
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Christoph Bürki
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Dietrich Klauwer
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
| | - Michael Hübler
- 1 Department for Congenital Cardiovascular Surgery, 2 Divisions of Pediatric Cardiology and Children's Research Centre, 3 Department for Anesthesiology, 4 Department of Intensive Care and Neonatology, University Children's Hospital, Zurich, Switzerland
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Lee HJ, Kim N, Lee H, Shim JK, Song JW. Persistent Left Superior Vena Cava Detected Incidentally after Pulmonary Artery Catheterization. Korean J Crit Care Med 2015. [DOI: 10.4266/kjccm.2015.30.1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Du L, Xie HN, Zhu YX, Li LJ, Peng R, Zheng J. Fetal persistent left superior vena cava in cases with and without chromosomal anomalies. Prenat Diagn 2014; 34:797-802. [PMID: 24711103 DOI: 10.1002/pd.4380] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/18/2014] [Accepted: 04/03/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The objectives of this study are to determine and compare the prevalence of persistent left superior vena cava (PLSVC) in chromosomally normal and abnormal fetuses and to evaluate the potential of PLSVC as a screening marker for chromosomal abnormalities. METHODS Women undergoing routine fetal sonographic examinations were evaluated once for the presence of PLSVC. PLSVC was diagnosed on the basis of the identification of an additional vessel in the left of the pulmonary artery in a three-vessel trachea view. Associated abnormalities, karyotypes, and outcomes were analyzed. RESULTS A total of 164 (0.7%, 164/25 171) cases of PLSVC were detected and successfully followed-up. The detection rates were 0.5% (81/17 535) and 1.1% (83/7636) in the low-risk and high-risk cases, respectively. The incidence of PLSVC was lower among the chromosomally or clinically normal (0.4%, 110/24 914) compared with chromosomally abnormal fetuses (7.8%, 20/257, p < 0.001). Additional defects were identified in 90% (18/20) of the PLSVC fetuses with chromosomal anomalies, a rate that was higher than those fetuses with chromosomal normal (61.8%, 68/110). CONCLUSIONS Persistent left superior vena cava is more common among chromosomally abnormal than normal fetuses, and PLSVC fetuses with other defects are more highly associated with chromosomal disorders than isolated PLSVC fetuses. Isolated PLSVC is a benign vascular anomaly and may not affect outcomes.
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Affiliation(s)
- Liu Du
- Department of Ultrasonic Medicine and Fetal Medical Centre, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Esmer AÇ, Yüksel A, Calı H, Ozsürmeli M, Omeroğlu RE, Kalelioğlu I, Has R. Prenatal diagnosis of persistent left superior vena cava and its clinical significance. Balkan Med J 2014; 31:50-4. [PMID: 25207167 DOI: 10.5152/balkanmedj.2014.9426] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 12/26/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Persistent left superior vena cava (PLSVC) is a variant of systemic venous return which is observed in 0.3% of autopsies in the general population and in 4-8% of patients with congenital heart disease. AIMS To evaluate associated cardiac, extracardiac and chromosomal anomalies in prenatally diagnosed cases of PLSVC and to review their outcome. STUDY DESIGN Retrospective comparative study. METHODS The data of patients with a prenatal diagnosis of PLSVC between May 2008 and January 2013 were reviewed retrospectively. RESULTS Data of 31 cases were reviewed. Fifteen (48.4%) cases were associated with cardiac defects and 17 (54.8%) cases had associated extracardiac sonographic or postpartum findings. Two fetuses had karyotype anomalies. Outcome was significantly more favorable in cases not associated with cardiac defects in comparison to those associated with cardiac anomalies (84.6% vs. 33.3%, p=0.009). All cases with isolated PLSVC survived, while among the cases associated with extracardiac anomalies, with cardiac anomalies and with both extra-cardiac and cardiac anomalies, the survival rate was 75%, 50% and 22.2%, respectively. The most frequent group of cardiac anomalies associated with PLSVC was septal defects and VSD was the most common heart defect individually, being observed in nine fetuses. CONCLUSION Prenatally diagnosed PLSVC is associated with cardiac and extracardiac anomalies in the majority of cases. Outcome is significantly worse if PLSVC is associated with a cardiac defect, and the prognosis is excellent in isolated cases.
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Affiliation(s)
- Aytül Çorbacıoğlu Esmer
- Department of Obstetrics and Gynecology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Atıl Yüksel
- Department of Obstetrics and Gynecology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Halime Calı
- Department of Obstetrics and Gynecology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Mehmet Ozsürmeli
- Department of Obstetrics and Gynecology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Rukiye Eker Omeroğlu
- Department of Pediatric Cardiology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Ibrahim Kalelioğlu
- Department of Obstetrics and Gynecology, İstanbul University Faculty of Medicine, İstanbul, Turkey
| | - Recep Has
- Department of Obstetrics and Gynecology, İstanbul University Faculty of Medicine, İstanbul, Turkey
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31
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Kazmi A, Gupta A, Grover V, Gupta VK. Persistent left superior vena cava with absent right superior vena cava-an incidental intraoperative finding. Indian J Thorac Cardiovasc Surg 2014. [DOI: 10.1007/s12055-013-0258-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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32
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Sheikh AS, Mazhar S. Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava: Review of the Literature and Clinical Implications. Echocardiography 2014; 31:674-9. [DOI: 10.1111/echo.12514] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Azeem S. Sheikh
- Southend University Hospital; NHS Foundation Trust; Westcliff-on-Sea Essex United Kingdom
| | - Sajjad Mazhar
- Southend University Hospital; NHS Foundation Trust; Westcliff-on-Sea Essex United Kingdom
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Agarwal A, K S R, Agrawal N, Patra S, Agarwal N, Manjunath CN. Persistent left superior vena cava draining into left atrium as a cause of persistent systemic desaturation after surgery. Echocardiography 2014; 31:E77-9. [PMID: 24372822 DOI: 10.1111/echo.12466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
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.
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Affiliation(s)
- Ashish Agarwal
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India
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Perles Z, Nir A, Gavri S, Golender J, Tashma A, Ergaz Z, Rein AJJT. Prevalence of persistent superior vena cava and association with congenital heart anomalies. Am J Cardiol 2013; 112:1214-8. [PMID: 23890574 DOI: 10.1016/j.amjcard.2013.05.079] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/31/2013] [Accepted: 05/31/2013] [Indexed: 11/19/2022]
Abstract
A contralateral persistent superior vena cava (PSVC) can occur in a normal child or in association with congenital heart defects (CHDs). Its prevalence has been demonstrated in relatively small cohorts. We aim to assess the frequency of a PSVC in a large cohort of children with and without CHDs. To estimate its significance, we have searched for a PSVC in all children referred for echocardiography in our institution during a 16.5-year period. A group of 17,219 children comprised 8,140 children with a structural heart anomaly and 9,079 children with a structurally normal heart. Association between a PSVC and specific classes of CHD were looked for. A total of 288 children (1.7%) had a PSVC; 0.56% (51 of 9,079) in the normal heart group and 2.9% (237 of 8,140) in the congenital heart anomalies group. Odds ratio for having heart anomaly in the presence of PSVC was 5.2 (95% confidence interval 3.7 to 7.0). A PSVC was above all associated with atrioventricular septal defects, conotruncal malformations, and left-sided defects. The odds ratio of having PSVC in the aforementioned malformations compared with the normal heart group was 23.8, 13.6, and 11.0, respectively. In conclusion, although present in normal subjects, PSVC was more often associated with congenital heart and other anomalies, especially with atrioventricular septal defects, conotruncal malformations, and left-sided defects.
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Affiliation(s)
- Zeev Perles
- Department of Pediatric Cardiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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Eldin GS, El-Segaier M, Galal MO. High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia. Libyan J Med 2013; 8:21679. [PMID: 24107708 PMCID: PMC3794077 DOI: 10.3402/ljm.v8i0.21679] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/13/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Persistent left superior vena cava (LSVC) is one of the common anomalies of the systemic veins. Its prevalence is 0.1-0.3% in the general population and is more common with congenital heart disease (CHD). The importance of detecting persistent LSVC prior to cardiac surgery is paramount for systemic veins cannulations. AIM The aim was to evaluate the prevalence of persistent LSVC in patients with CHD in Saudi Arabia. METHODS All patients referred to our institution had echocardiography. All complete studies were reviewed for the presence of persistent LSVC. A computerized database was created including the demographic data, CHD diagnoses, and the presence of persistent LSVC. RESULTS A total of 2,042 were examined with an age range of 1 day to 16 years. The complete echocardiographic studies were 1,832 (90%) of whom 738 (40%) patients had CHD. The prevalence of persistent LSVC in patients with CHD was 7.8% (OR 9.26, 95% CI 4.7-18.2, p<0.001). The most common cardiac defect associated with persistent LSVC was complete atrioventricular septal defect (AVSD); all patients with AVSD had Down syndrome. The total number of patients with AVSD was 41, and persistent LSVC was found in 11 (26%) of them (odds ratio 5.1, 95% CI 2.4-10.8, p<0.001). CONCLUSIONS The prevalence of persistent LSVC in the current population is almost double the reported prevalence obtained using the same echocardiographic screening tool.
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Affiliation(s)
- Ghada Shiekh Eldin
- Department of Paediatric Cardiology, PSHC, King Fahd Medical City, Riyadh, Saudi Arabia
| | - Milad El-Segaier
- Department of Paediatric Cardiology, PSHC, King Fahd Medical City, Riyadh, Saudi Arabia
- Department of Paediatric Cardiology, Skåne University Hospital, Lund, Sweden
| | - Mohammed Omer Galal
- Department of Paediatric Cardiology, PSHC, King Fahd Medical City, Riyadh, Saudi Arabia
- Department of Paediatric Cardiology, University of Essen, Essen, Germany
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Vijayvergiya R, Shrivastava S, Kumar A, Otaal PS. Transvenous defibrillator implantation in a patient with persistent left superior vena cava. World J Cardiol 2013; 5:109-111. [PMID: 23675558 PMCID: PMC3653011 DOI: 10.4330/wjc.v5.i4.109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 11/28/2012] [Accepted: 03/09/2013] [Indexed: 02/06/2023] Open
Abstract
Persistent left superior vena cava (LSVC) can be incidentally detected during pacemaker implantation through left pectoral side. There is technical difficulty of optimal site pacing and lead stability for right ventricle lead in such situation. We hereby report a case of successful single-chamber implantable cardioverter defibrillator (ICD) implantation in a 50 years-old male with LSVC. The practical issues related with right ventricle lead implantation and pacing/defibrillation parameters for ICD device are discussed.
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Bader M, Bromley P, Jester I, Bennett J, Arul GS. Central venous catheters in the left-sided superior vena cava: clinical implications. J Pediatr Surg 2013; 48:400-3. [PMID: 23414873 DOI: 10.1016/j.jpedsurg.2012.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 11/12/2012] [Indexed: 11/19/2022]
Abstract
AIM Left-sided superior vena cava (LSVC) is a congenital venous anomaly with an incidence of about 0.3%, and which is sometimes discovered during vascular intervention [Le Cat. Histoire de l'acadroyale des sciences .Paris 1738:62, I Steinberg, W Dubilier, D Lucas. Persistence of left superior vena cava. Dis Chest 1953;24:479-88]. There is little clear guidance on what to do in this event. METHODS Children with LSVC were identified from our prospectively collected database of percutaneous central venous catheter (CVC) insertions between 2004 and 2011. If a LSCV was suspected, usually a venogram was performed. All available documentation was reviewed to identify complications. RESULTS Eleven children with LSVC had 12 CVCs during the study period. Mean age at operation was 5.8 years (range 27 days to 15 years). Cardiovascular anomalies were already known in three cases. After CVC insertion, the line tip lay in the LSVC in eight cases and in the RA in 4. In 11 cases there was no immediate problem, but in 1 case there were postoperative bradyarrhythmias, which caused the CVC to be removed on day 1. This case was later found to have abdominal sepsis. The mean duration the CVCs were retained was 331days (range 1 day to 4 years). Other reasons for CVC removal were infection (n=1), damaged line (n=2), no longer required (n=2), and death unrelated to CVC (n=2). CONCLUSIONS Our experience suggests that a LSVC (i) is often first discovered during CVC insertion, (ii) can be safely used for parenteral nutrition or chemotherapy, and (iii) the best practice would be to leave the CVC tip high in the LSVC or in the RA via another route.
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Affiliation(s)
- Mohammad Bader
- Department of Paediatric Surgery, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.
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38
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Aperis G, Paliouras C, Moschos N, Tsampikaki E, Alivanis P. SLOW CONTINUOUS ULTRAFILTRATION IN A PATIENT WITH ANOMALY OF A PERSISTENT LEFT SUPERIOR VENA CAVA. J Ren Care 2012; 38:151-4. [DOI: 10.1111/j.1755-6686.2012.00256.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Weymann A, Schmack B, Karck M, Szabo G. Orthotopic Heart Transplantation in a Patient with Persistent Left Superior Vena Cava. Ann Thorac Cardiovasc Surg 2012; 18:554-6. [DOI: 10.5761/atcs.cr.11.01828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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40
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Ichikawa T, Sekiguchi T, Kawada S, Koizumi J, Endo J, Yamada Y, Ito C, Sugiyama M, Terachi T, Usui Y, Torigoe K, Imai Y. Study of the Association Between an Anomalous Superior Vena Cava and Horseshoe Kidney. Circ J 2012; 76:1253-8. [DOI: 10.1253/circj.cj-11-0874] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tamaki Ichikawa
- Department of Radiology, Tokai University School of Medicine
| | | | - Shuichi Kawada
- Department of Radiology, Tokai University School of Medicine
| | - Jun Koizumi
- Department of Radiology, Tokai University School of Medicine
| | - Jun Endo
- Department of Radiology, Tokai University School of Medicine
| | - Yuri Yamada
- Department of Radiology, Tokai University School of Medicine
| | - Chihiro Ito
- Department of Radiology, Tokai University School of Medicine
| | - Makoto Sugiyama
- Department of Radiological Technology, Tokai University School of Medicine
| | | | - Yukio Usui
- Department of Urology, Tokai University School of Medicine
| | - Kojun Torigoe
- Department of Anatomy, Tokai University School of Medicine
| | - Yutaka Imai
- Department of Radiology, Tokai University School of Medicine
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Successful percutaneous cardiac resynchronization despite an occlusive Thebesian valve. Pediatr Cardiol 2011; 32:1223-7. [PMID: 21805325 DOI: 10.1007/s00246-011-0066-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 07/09/2011] [Indexed: 10/17/2022]
Abstract
We report the case of a patient with symptomatic heart failure referred after an unsuccessful attempt at cardiac resynchronization therapy. An occlusive Thebesian valve prevented entry into the coronary sinus ostium. Careful analysis of the patient's cardiovascular physiology and anatomy revealed the "fortuitous" presence of a persistent left superior vena cava. Cannulation of this vessel permitted percutaneous retrograde placement of a left ventricular lead into a posterolateral cardiac venous branch resulting in successful cardiac resynchronization. This unique case provides strong evidence that thorough knowledge of cardiac embryology, anatomy, and physiology plays a pivotal role in percutaneous electromechanical intervention for drug-refractory heart failure.
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Kula S, Cevik A, Sanli C, Pektas A, Tunaoglu FS, Oguz AD, Olgunturk R. Persistent left superior vena cava: experience of a tertiary health-care center. Pediatr Int 2011; 53:1066-9. [PMID: 21810152 DOI: 10.1111/j.1442-200x.2011.03443.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to assess the prevalence of persistent left superior vena cava (PLSVC) in patients with all types of congenital heart defects and to determine the congenital heart anomalies accompanying PLSVC. METHODS The present study is based on a retrospective review of 1205 children who consecutively underwent cardiac catheterization from 2000 to 2007. In order to determine the existence of PLSVC, all the subjects routinely underwent superior vena cava (SVC) injection during angiography at the catheter laboratory of the study center. RESULTS The prevalence of PLSVC was computed to be 6.1% for the present study population. Transthoracic echocardiography was able to detect PLSVC in 32 children (2.6%) whereas angiography diagnosed PLSVC in 74 children (6.1%). The mean age of the patients with PLSVC was 40.09 ± 50.21 months. A communication between the right and left SVC was determined in 27% of the children who were diagnosed with PLSVC after angiography was performed (20 out of 74). A statistically significant association was present between PLSVC and other congenital cardiac anomalies, including ventricular septal defect (n= 42, 56.8%), atrial septal defect (n= 31, 41.9%), pulmonary stenosis (n= 19, 25.7%), atrioventricular septal defect (n= 10, 13.5%), patent ductus arteriosus (n= 6, 8.1%) and cor triatriatum (n= 3, 4.1%). CONCLUSION Transthoracic echocardiography usually visualizes dilated coronary sinus in association with PLSVC. However, SVC injection should be performed in patients undergoing angiography so that morbidity and mortality related with persistent left superior vena cava can be avoided during cardiovascular surgery.
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Affiliation(s)
- Serdar Kula
- Gazi University Faculty of Medicine, Department of Pediatric Cardiology, Besevler, Ankara, Turkey.
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Kurtoglu E, Cakin O, Akcay S, Akturk E, Korkmaz H. Persistent Left Superior Vena Cava Draining into the Coronary Sinus: A Case Report. Cardiol Res 2011; 2:249-252. [PMID: 28357015 PMCID: PMC5358287 DOI: 10.4021/cr85w] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2011] [Indexed: 12/04/2022] Open
Abstract
Persistent left superior vena cava (PLSVC) is a congenital anomaly of the thoracic venous system resulting from the abnormal persistence of an embryological vessel that normally regresses during early fetal life. This anomaly is often discovered incidentally during surgery, cardiovascular imaging or invasive cardiovascular procedures. In most cases, a PLSVC drains into the right atrium through the coronary sinus. In the remainder of cases, it enters directly or through the pulmonary veins into the left atrium. A dilated coronary sinus on echocardiography should always raise the suspicion of a PLSVC as it has important clinical implications. The diagnosis should be confirmed by saline contrast echocardiography. We report a patient with persistent left superior vena cava with an enlarged coronary sinus and normal right superior vena cava.
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Affiliation(s)
- Ertugrul Kurtoglu
- Elazig Training and Research Hospital, Clinic of Cardiology, Elazig, Turkey
| | - Ozlem Cakin
- Harput State Hospital, Clinic of Internal Medicine, Elazig, Turkey
| | | | - Erdal Akturk
- Adiyaman University, Department of Cardiology, Adiyaman, Turkey
| | - Hasan Korkmaz
- Elazig Training and Research Hospital, Clinic of Cardiology, Elazig, Turkey
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44
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[Persistent left superior vena cava in a 2-month-old infant]. ACTA ACUST UNITED AC 2011; 58:266. [PMID: 21608292 DOI: 10.1016/s0034-9356(11)70058-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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45
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Taweevisit M, Thorner PS. Persistent left superior vena cava: does it have a role in the pathogenesis of hypoplastic left heart syndrome? Pediatr Dev Pathol 2011; 14:105-10. [PMID: 20715969 DOI: 10.2350/10-05-0823-oa.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The coexistence of a persistent left superior vena cava (PLSVC) and congenital anomalies, both cardiac and noncardiac, is well documented, but whether PLSVC contributes to the development of cardiac malformations is controversial. We conducted a retrospective review of perinatal and pediatric autopsies to determine the association between PLSVC and other congenital anomalies. Of 362 patients, 91 (25%) had congenital heart disease and 19 (5.2%) had PLSVC. Eight cases (47%) were associated with specific syndromes, including heterotaxy syndrome, trisomy 18, trisomy 13, and Jacobsen syndrome. Seventeen cases of PLSVC (89%) were associated with congenital heart disease, most of which were complex. Isolated PLSVC was found in 2 cases (11%). Eight of the 19 PLSVC cases (47%) were associated with hypoplastic left heart syndrome (HLHS), a result that was statistically significant (P = 0.041). Left ventricle inflow/outflow obstruction is believed to be a critical pathogenic factor in the development of HLHS. Whereas 5 of 8 cases of HLHS had additional obstructive cardiac outflow tract lesions, 3 of 8 cases did not. PLSVC is known to be able to compromise left ventricle inflow via a dilated coronary sinus, and we speculate that PLSVC may have played a contributing role in the pathogenesis of HLHS in these three cases. As an isolated lesion, PLSVC would not be sufficient to cause HLHS, but it might contribute in combination with other obstructive lesions, or in the setting of other genetic and/or environmental factors still to be defined for HLHS. A larger series will be needed to confirm this hypothesis.
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Affiliation(s)
- Mana Taweevisit
- Department of Pathology, Chulalongkorn University, Pathumwan, Bangkok, Thailand.
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Talwar S, Upadhyay M, Choudhary SK, Kothari SS, Anderson RH, Airan B. Interatrial communication with unusual caval venous anomalies. World J Pediatr Congenit Heart Surg 2010; 1:400-3. [PMID: 23804896 DOI: 10.1177/2150135110379621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a 3-year-old patient with a rare combination of a sinus venosus interatrial communication, anomalous drainage of the right superior pulmonary vein to the right atrium, persistent left superior caval vein, and interruption of the inferior caval vein. We discuss features of anatomical and technical interest.
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Affiliation(s)
- Sachin Talwar
- Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India
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47
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Jacob M, Sokoll A, Mannherz HG. A case of persistent left and absent right superior caval vein: An anatomical and embryological perspective. Clin Anat 2010; 23:277-86. [PMID: 20169608 DOI: 10.1002/ca.20945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The relatively common persistent left superior caval vein (LSCV) is in most cases associated with doubling of the superior caval vein. A persistent LSCV with absent right superior caval vein (RSCV)-a rather rare event-was found during our course of gross anatomy. The LSCV drained into an enlarged coronary sinus, which was partly accompanied by an apparent "double" sinus of normal size draining into this enlarged coronary sinus. Histological and immunofluorescence studies using antibodies against smooth and cardiac muscle actins were performed. The terminal part of the LSCV near the opening into the right atrium contained cardiac actin as expected for a normal derivative of the left sinus horn. Previously only one case of doubled coronary sinus with LSCV has been reported and this abnormality was explained by splitting of the sinus. In our case, the partly doubled coronary sinus had the structure of coronary veins. Mechanical forces have been invoked for the obliteration of the LSCV. Therefore, we examined thirteen human embryos from 15 mm to 32 mm crown-rump length. In one embryo, we found a persistent LSCV together with an enormously enlarged left atrium. Contrary to previous suggestions our data indicate that during normal development a compression of the left anterior cardinal vein does not sufficiently explain the obliteration of the left and the persistence of the right vein. We therefore believe that beside a left dominated blood flow of head and arm, genes for left-right signaling may have to be taken into consideration.
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Affiliation(s)
- Monika Jacob
- Department of Anatomy and Embryology, Ruhr University Bochum, Bochum, Germany
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48
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Persistent Left Superior Vena Cava Diagnosed by Bedside Echocardiography. J Emerg Med 2010; 38:638-41. [DOI: 10.1016/j.jemermed.2008.05.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2008] [Revised: 04/29/2008] [Accepted: 05/23/2008] [Indexed: 11/21/2022]
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49
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Jaramillo JF, Estrada Perea MH, Muriel YY. Persistencia de la vena cava superior izquierda. Diagnóstico e importancia prenatal. REVISTA COLOMBIANA DE CARDIOLOGÍA 2010. [DOI: 10.1016/s0120-5633(10)70221-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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50
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Tsutsui K, Ajiki K, Fujiu K, Imai Y, Hayami N, Murakawa Y. Successful Catheter Ablation of Atrial Tachycardia and Atrial Fibrillation in Persistent Left Superior Vena Cava. Int Heart J 2010; 51:72-4. [DOI: 10.1536/ihj.51.72] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Kenta Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Kohsuke Ajiki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Yasushi Imai
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Noriyuki Hayami
- 4th Department of Internal Medicine, Teikyo University School of Medicine University Hospital
| | - Yuji Murakawa
- 4th Department of Internal Medicine, Teikyo University School of Medicine University Hospital
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