1
|
Cha YE, Ro WB, Song SJ, Lee MK, Kang MH, Park HM. Case report: A novel occurrence of persistent left cranial vena cava coexisting with polycystic kidney disease in a cat. Front Vet Sci 2023; 10:1268493. [PMID: 37869489 PMCID: PMC10585034 DOI: 10.3389/fvets.2023.1268493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
A 7-year-old castrated male Munchkin cat was presented with anorexia. This cat had been diagnosed with chronic kidney disease due to polycystic kidney disease. Tachycardia with a systolic murmur (grade III/VI) was auscultated and for further diagnosis, echocardiography was performed. Based on echocardiography, persistent left cranial vena cava (PLCVC) was suspected due to enlargement of the coronary sinus and confirmed by saline contrast echocardiography. The dilated coronary sinus compressed the left atrium, and left ventricular hypertrophy with the systolic anterior motion of the mitral valve, aortic regurgitation, and mitral regurgitation were identified. After medical management using atenolol, left atrial function and other hemodynamics of the heart were improved, including the disappearance of regurgitation and normalization of left ventricular wall thickness. This case report describes the echocardiographic characteristics, diagnostic procedures, and disease progression in a cat with PLCVC after medical management using atenolol. Additionally, this is the first report of a cat with PLCVC, coexisting with polycystic kidney disease.
Collapse
Affiliation(s)
- Ye-Eun Cha
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
| | - Woong-Bin Ro
- Department of Veterinary Emergency and Critical Care Medicine, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Seung-Ji Song
- Cat Vet Animal Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Mi-Kyung Lee
- Cat Vet Animal Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Min-Hee Kang
- Department of Bio-animal Care, Jangan University, Hwaseong-si, Gyeonggi-do, Republic of Korea
| | - Hee-Myung Park
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
| |
Collapse
|
2
|
Henckell AK, Gusetu G, Rosu R, Ciobanu DM, Istratoaie S, Muresan L, Lazea C, Pop D, Cismaru G, Bârsu C, Popa SL, Negru AG, Cismaru A, Zdrenghea D, Cainap SS. Low Atrial Rhythm in a Large Cohort of Children from Transylvania, Romania. Life (Basel) 2022; 12:1895. [PMID: 36431031 PMCID: PMC9697869 DOI: 10.3390/life12111895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/05/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022] Open
Abstract
Low atrial rhythm (LAR) is an ectopic rhythm originating in the lower part of the right or left atrium. Prior observational studies attempted to quantify the prevalence of low atrial rhythm in the pediatric population, but the observed prevalence was highly variable with relatively small sample sizes. We aimed to characterize low atrial rhythm and determine its prevalence in a large population of 24,316 asymptomatic children from northwestern Transylvania. We found a prevalence of 0.6% (145 children) for low atrial rhythm. Children with LAR had a significantly lower heart rate (mean 78.6 ± 8.3 bpm), than the control sinus rhythm group (85.02 ± 4.5 bpm). Furthermore, a shorter PR interval was seen in children with LAR (132.7 ± 12.7 ms) than in the children from the control group (141.7 ± 5.4; p = 0.0001).There was no significant association between gender and the presence of left LAR (LLAR) or right LAR (RLAR) (p = 0.5876). The heart rate of children with LLAR was significantly higher (81.7 ± 11.6 bpm) than that of the children with LRAR (77.6 ± 11.1 bpm) (p = 0.037). Pediatric cardiologists should recognize low atrial rhythm and be aware that asymptomatic, healthy children can exhibit this pattern, which does not require therapeutic intervention.
Collapse
Affiliation(s)
- Anne-Kathrin Henckell
- 5th Department of Internal Medicine, Cardiology Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Gabriel Gusetu
- 5th Department of Internal Medicine, Cardiology Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Radu Rosu
- 5th Department of Internal Medicine, Cardiology Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Dana Mihaela Ciobanu
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Sabina Istratoaie
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Lucian Muresan
- Cardiology Department, Emile Muller Hospital, 68100 Mulhouse, France
| | - Cecilia Lazea
- Department of Pediatrics I, Emergency Clinic Hospital for Children, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Dana Pop
- 5th Department of Internal Medicine, Cardiology Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Gabriel Cismaru
- 5th Department of Internal Medicine, Cardiology Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cristian Bârsu
- Department of Abilities—Humanistic Sciences, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Stefan Lucian Popa
- 5th Department of Internal Medicine, Medical Clinic No 2, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Alina Gabriela Negru
- Department of Cardiology, Victor Babeș University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania
| | - Andrei Cismaru
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Dumitru Zdrenghea
- 5th Department of Internal Medicine, Cardiology Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Simona Sorana Cainap
- Department of Pediatrics II, Emergency Clinic Hospital for Children, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| |
Collapse
|
3
|
Jeong ER, Kang EJ, Jeun JH. Pictorial Essay: Understanding of Persistent Left Superior Vena Cava and Its Differential Diagnosis. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:846-860. [PMID: 36238921 PMCID: PMC9514584 DOI: 10.3348/jksr.2021.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/01/2022] [Accepted: 02/21/2022] [Indexed: 06/16/2023]
Abstract
Persistent left superior vena cava (PLSVC) is a rare congenital, thoracic, and vascular anomaly. Although PLSVCs generally do not have a hemodynamic effect, several types of PLSVC and some cardiac anomalies may manifest with clinical symptoms. The presence of PLSVC can render catheterization via left subclavian access difficult when placing a pacemaker or central venous catheter. As such, recognizing a PLSVC that is typically incidentally discovered can prevent complications such as vascular injury. Differentiating vessels found in a similar location as PLSVC is necessary when performing thoracic vascular procedures. This pictorial essay explains the multi-detector CT findings of a PLSVC, and provides a summary of other blood vessels that require differentiation during thoracic vascular procedures.
Collapse
|
4
|
Samara OA, Alzoubi O, Gharaibeh AM, Alnajjar Q, Alawwa I. Isolated Persistent Left Superior Vena Cava Associated With Autosomal Dominant Polycystic Kidney Disease (ADPKD): Challenges and Clinical Significance. Cureus 2022; 14:e22890. [PMID: 35399489 PMCID: PMC8986345 DOI: 10.7759/cureus.22890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 11/05/2022] Open
|
5
|
Samiei N, Akiash N, Djafari Naeini S, Nikpajouh A, Pazoki M. The Presence of Patent Foramen Ovale in the Superior Type of Sinus Venosus Atrial Septal Defect. J Tehran Heart Cent 2020; 15:98-104. [PMID: 33552204 PMCID: PMC7827115 DOI: 10.18502/jthc.v15i3.4218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: The superior type of sinus venosus atrial septal defect (SVASD) is a rare form of the atrial septal defect (ASD) in which the upper part of the atrial septum does not exist. The presence of other cardiac anomalies such as anomalous pulmonary venous connections has been reported in this type of congenital heart disease. This study aimed to assess the presence of the patent foramen ovale (PFO) in patients with the superior type of SVASD. Methods: This retrospective case-control study on 387 patients, consisting of 187 patients with a definite SVASD and 200 patients with problems other than the ASD, was conducted in Rajaie Cardiovascular Medical and Research Center between February 2005 and July 2014. Seven patients with inadequate data were excluded from the analysis. The presence/absence of the PFO was also evaluated in the case and control groups. Results: The analyses were performed on 182 male and 198 female patients at a mean age of 39.07±14.41 and 51.01±15.80 years in the case and control groups, respectively. The PFO was significantly more frequent in the patients with the superior type of SVASD than in those without the condition (P<0.001). The persistence of the left superior vena cava was seen in 34 out of 180 patients with SVASD and in 1 out of 200 patients without the condition (18.9% vs 0.5%; P<0.001). Conclusion: This study was the first to highlight the coexistence of the PFO and the superior type of SVASD. Physiological, genetic, or fetal factors may play an important role in the association between the PFO and the SVASD.
Collapse
Affiliation(s)
- Niloufar Samiei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nehzat Akiash
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sepideh Djafari Naeini
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akbar Nikpajouh
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Pazoki
- Rasul Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
6
|
Kobayashi M, Ichikawa T, Koizumi J, Hashimoto J, Yamamuro H, Hara T, Nomura T, Kanda S, Imai Y. Aberrant Left Brachiocephalic Vein versus Persistent Left Superior Vena Cava without Bridging Vein in Adults: Evaluation on Computed Tomography. Ann Vasc Dis 2018; 11:535-541. [PMID: 30637011 PMCID: PMC6326043 DOI: 10.3400/avd.oa.18-00098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objective: Persistent left superior vena cava without bringing vein (PLSVC w/o BV) is a common thoracic venous anomaly, while aberrant left brachiocephalic vein (ALBCV) is an uncommon condition. We compared the incidences of the two venous anomalies and assessed congenital cardiovascular diseases (CCDs) in adults using computed tomography (CT). Materials and Methods: We reviewed the recorded reports or CT images of 49,494 adults for PLSVC w/o BV and ALBCV in two hospitals. We determined incidences of two venous anomalies and the rate of associated CCDs. Results: 76 PLSVCs w/o BV and 27 ALBCVs were found. The incidence of PLSVC w/o BV was 0.15% and the incidence of ALBCV was 0.055%. PLSVC w/o BV had higher incidence than ALBCV (p<0.001). Four PLSVCs w/o BV and one ALBCV were associated with congenital heart diseases. Two PLSVCs w/o BV and four ALBCVs were associated with congenital aortic arch anomaly (CAAA). ALBCV had higher incidence of associated CAAA than PLSVC w/o BV (P=0.02). Conclusion: The incidence of ALBCV was <50% that of PLSVC w/o BV. The two venous anomalies found on CT during adulthood were rarely associated with CCDs.
Collapse
Affiliation(s)
- Makiko Kobayashi
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.,Division of Diagnostic Radiology, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan
| | - Tamaki Ichikawa
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Jun Koizumi
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Jun Hashimoto
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hiroshi Yamamuro
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Takuya Hara
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Takakiyo Nomura
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Shigetaka Kanda
- Department of Cardiac Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yutaka Imai
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| |
Collapse
|
7
|
Moradian M, Mortezaeian H, Baghaei R, Ghadrdoost B. Left Atrial Drainage of the Right Superior Vena Cava: A Case Report. J Tehran Heart Cent 2018; 13:84-87. [PMID: 30483319 PMCID: PMC6246439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
An isolated right superior vena cava (RSVC) draining into the left atrium represents a very rare congenital malformation, especially in the absence of a partial anomalous pulmonary venous return. This condition leads to hypoxemia, cyanosis, and clubbing without any other signs of heart defects. We describe an 8-year-old girl, who was referred to our hospital due to unexplained cyanosis. Segmental approach in transthoracic echocardiography showed left atrial drainage of the RSVC, which was subsequently confirmed by contrast echocardiography and angiography. Surgical repair via trans-section and anastomosis of the superior vena cava to the right atrium was performed to prevent the complications of right-to-left shunting and cyanosis. During a 4-year follow-up, the patient remained in very good clinical status and her serial echocardiography was normal except for very mild left atrial and left ventricular enlargement.
Collapse
Affiliation(s)
- Maryam Moradian
- Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Hojjat Mortezaeian
- Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.,Corresponding Author: Hojjat Mortezaeian, Associated Professor of Pediatric Cardiology, Rajaie Cardiovascular, Medical and Research Center, Mellat Park, Vali-e-Asr Avenue, Tehran, Iran. 1996911151. Tel: +98 21 23922161. Fax: +98 21 23922782.E-mail: .
| | - Ramin Baghaei
- Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Behshid Ghadrdoost
- Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
8
|
Rio PP, Mumpuni H, Anggrahini DW, Dinarti LK. Persistent left superior vena cava in atrial septal defect sinus venosus type: diagnosis with saline contrast echocardiography-a case series. Clin Case Rep 2017; 5:587-590. [PMID: 28469854 PMCID: PMC5412825 DOI: 10.1002/ccr3.883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/27/2016] [Accepted: 10/14/2016] [Indexed: 11/28/2022] Open
Abstract
Persistent Left Superior Vena Cava (PLSVC) should be suspected if we find dilatation of coronary sinus. Sophisticated imaging is not always available in each health care provider. Transthoracic echocardiography (TTE) with agitated saline injections through the left and right antecubital veins provides a simple, and inexpensive, but effective study for a rapid bedside diagnosis of PSLVC.
Collapse
Affiliation(s)
- Purwati Pole Rio
- Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Gadjah Mada,-Sardjito General Hospital Yogyakarta Indonesia
| | - Hasanah Mumpuni
- Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Gadjah Mada,-Sardjito General Hospital Yogyakarta Indonesia
| | - Dyah Wulan Anggrahini
- Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Gadjah Mada,-Sardjito General Hospital Yogyakarta Indonesia
| | - Lucia Kris Dinarti
- Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Gadjah Mada,-Sardjito General Hospital Yogyakarta Indonesia
| |
Collapse
|
9
|
Inability to Utilize Retrograde Cardioplegia due to a Persistent Left Superior Vena Cava. Case Rep Anesthesiol 2017; 2017:4671856. [PMID: 29333298 PMCID: PMC5733155 DOI: 10.1155/2017/4671856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/16/2017] [Accepted: 11/05/2017] [Indexed: 01/07/2023] Open
Abstract
A persistent left superior vena cava is a congenital abnormality that affects a minority of the general population. While this finding is not hemodynamically significant in all patients, failure to recognize the altered anatomy in any of these patients can be consequential during procedures such as central venous catheter placement, pacemaker/defibrillator wire placement, and use of retrograde cardioplegia during cardiac surgery. We present a case of an intraoperative diagnosis of a persistent left superior vena cava that altered the original plan to arrest the heart using retrograde cardioplegia. Echocardiography was instrumental in this diagnosis and avoided potentially inadequate myocardial protection during cardiopulmonary bypass.
Collapse
|
10
|
Emam ARA, Abuzaid AS, Chamsi-Pasha M, Sricharoen N. Right Heart Catheterization Through Persistent Left Superior Vena Cava, an Extremely Rare Procedure and Review of Current Literature. Curr Cardiol Rev 2016; 13:106-109. [PMID: 27799028 PMCID: PMC5452146 DOI: 10.2174/1573403x12666161028151339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 10/18/2016] [Accepted: 10/21/2016] [Indexed: 11/22/2022] Open
Abstract
Persistent left superior vena cava (PLSVC) is encountered occasionally during angiographic procedures. It usually coexists with right superior vena cava and drains to the right atrium through the coronary sinus, but multiple variations are described. Although PLSVC is extensively reported in the literature, there are very few articles addressing right heart catheterization in patients with isolated PLSVC. We present a patient with absent right superior vena cava and PLSVC draining to a dilated coronary sinus diagnosed during right heart catheterization in the setting of pulmonary hypertension. We were able to safely complete the procedure through the right internal jugular vein. Transthoracic echocardiography and chest CT scan were consistent with this finding. Although clinically silent most of the time, undiagnosed PLSVC can lead to catastrophic consequences when the patient undergoes invasive procedures. If PLSVC is suspected, the anatomy of the thoracic venous system must be identi-fied before invasive cardiac procedures.
Collapse
Affiliation(s)
- Abdel Rahman Al Emam
- University of Nebraska Medical Center, Department of Cardiology, 982265 Nebraska Medical Center, Omaha, NE 68198-2265, United States
| | - Ahmed Sami Abuzaid
- Sidney Kimmel Medical College at Thomas Jefferson University/Christiana Care Health System, Cardiology department, Heart and Vascular Institute, Delaware, Newark, United States
| | | | | |
Collapse
|
11
|
Prasanna LC, Thomas HR, Das A, Kumar R. Left-Sided Persistent Superior Vena Cava with Superior Hemiazygos Arch. J Clin Diagn Res 2016; 10:AD03-5. [PMID: 27437202 DOI: 10.7860/jcdr/2016/17785.7821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/29/2016] [Indexed: 11/24/2022]
Abstract
Persistent Left-side Superior Vena Cava (PLSVC) is the congenital central venous anomaly draining into the right atrium in 82-90% of cases via coronary sinus produce no haemodynamically significant consequences. In few cases it may drain into the left atrium directly or through the pulmonary veins resulting in right to left shunt. During routine undergraduate dissection, we found a PLSVC formed by the union of left subclavian and left internal jugular veins behind the left sternoclavicular joint was terminated into the right atrium through a larger coronary sinus ostium. Before its termination, PLSVC received a left hemiazygos vein formed by the continuation of the superior and inferior hemiazygos veins. A larger but thin communicating vein was noted between the right superior vena cava and PLSVC. Prior knowledge about such variations is essential in all the intervention procedures on right atrium through the left subclavian approach and also like in our case, the larger coronary sinus ostium if found during transthoracic echocardiography should be considered as an indication for the diagnosis of PLSVC.
Collapse
Affiliation(s)
| | - Huban R Thomas
- Senior Grade Lecturer, Department of Anatomy, Kasturba Medical College, Manipal University , Manipal, India
| | - Aswin Das
- Postgraduate Scholar, Department of Anatomy, Kasturba Medical College, Manipal University , Manipal, India
| | - Rakesh Kumar
- Postgraduate Scholar, Department of Anatomy, Kasturba Medical College, Manipal University , Manipal, India
| |
Collapse
|
12
|
Kim H, Kim JH, Lee H. Persistent left superior vena cava: diagnosed by bedside echocardiography in a liver transplant patient: a case report. Korean J Anesthesiol 2015; 67:429-32. [PMID: 25558346 PMCID: PMC4280483 DOI: 10.4097/kjae.2014.67.6.429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/07/2014] [Accepted: 01/08/2014] [Indexed: 11/29/2022] Open
Abstract
In most cases, persistent left superior vena cava (PLSVC) is asymptomatic and discovered accidentally. This case involves a 43-year-old male who underwent an emergency cadaveric liver transplantation. Postoperatively, the left internal jugular vein was cannulated using a sono-guided Seldinger technique in the intensive care unit. But the chest X-ray showed that the catheter followed the left paramediastinal course instead of crossing midline to the right to enter the superior vena cava. In consideration of the patient's status, an intra-arterial or extra-vascular placement could be excluded. For a diagnosis, we performed a bed-side transthoracic echocardiography with an agitated saline micro-bubble test. When agitated saline was injected through the catheter, the coronary sinus was initially opacified, and then the right atrium followed. In conclusion, we were able to make a diagnosis of PLSVC by a bedside test without radiation exposure.
Collapse
Affiliation(s)
- Hyerim Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jin Hee Kim
- Department of Anesthesiology and Pain Medicine, National University Bundang Hospital, Seongnam, Korea
| | - Hannah Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|