Address for correspondence: Lawrence Boxt, M.D. Division of Cardiology North Shore University Hospital 300 Community Drive Manhasset, NY 11 030, USA
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Images in Cardiology Images edited by James Hill, MD.
Persistent Left Superior Vena Cava Imaged by 64-detector Computed Tomography Sonia A. Henry, M.D., Amgad N. Makaryus, M.D., Lawrence Boxt, M.D. Department of Medicine, Division of Cardiology, North Shore University Hospital, Manhasset, New York, USA
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(B) Figure 1. Course of the persistent left superior vena cava (arrows). (A) Axial image through top of pulmonary artery (PA). The persistent left superior vena cava (arrow, LSVC) lies lateral to the top of the PA. The right superior vena cava (RSVC) is noted in its normal position. (B) Axial image at the level of the PA bifurcation. The persistent LSVC (arrow) lies anterior to the left upper lobe pulmonary vein (LUPV). The RSVC is again identified in its normal anatomical position. (C) The dilated coronary sinus (arrow, CS) drains into the right atrium (RA).
A 27-year-old man with a family history of coronary disease was referred for a 64-detector computed-tomographic angiography (CTA) for the evaluation of persistent chest pressure. The CTA revealed no coronary stenosis. An incidental finding of a persistent left-sided superior vena cava (LSVC) draining into a dilated coronary sinus was made (Figs. 1 and 2). The normal right Superior rena cava (SVC) drained to the right atrium. Persistent LSVC is the most common thoracic venous anomaly. It is an incidental finding
Received: May 12, 2006 Accepted: July 18, 2006
in 0.4% of the population and in 3–8% of patients with congenital heart disease. Congenital malformations commonly associated with persistent LSVC include atrial septal defect, cor triatrium, and mitral atresia.1
Reference 1.
Makaryus AN, Stechel R, Green S A rare combination of LMCA fistula to left superior vena cava with drainage into the coronary sinus in a 74-year-old woman. J Invasive Cardiol. 2003;15(5):270–272.
Clin. Cardiol. 32, 7, 1–2 (2009) Published online in Wiley InterScience. (www.interscience.wiley.com) DOI:10.1002/clc.20122 2009 Wiley Periodicals, Inc.
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Images in Cardiology
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Figure 2. Three-dimensional surface rendered 64-detector CT images. (A) The dialated CS is inferior to the left lower lobe pulmonary vein (LLPV). The dilated CS is inferior to the right lower lobe pulmonary vein (RUPV). (B) View from behind. The persistent LSVC drains cephalad to caudal, anterior to the left PA and left pulmonary veins to enter the posterior atrioventricular ring (arrow). It continues anterior to the left lower pulmonary vein (LLPV) to drain into the dilated CS. [LSVC = Left superior vena cava; CS = Coronary sinus; A = Aorta; PA = Pulmonary artery; LUPV = Left upper pulmonary vein; RUPV = Right upper pulmonary vein; LLPV = Left lower pulmonary vein; LV = Left ventricle; LA = Left atrium; LAA = Left atrial appendage].
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Clin. Cardiol. 32, 7, 1–2 (2009) Lawrence B. et al: S. A. Henry et al. Persistent left superior vena cava Published online in Wiley InterScience. (www.interscience.wiley.com) DOI:10.1002/clc.20122 2009 Wiley Periodicals, Inc.
