Medicine:Persistent left superior vena cava
| Persistent left superior vena cava | |
|---|---|
 | |
| The (right) superior vena cava (on left) and the left brachiocephalic vein (here labeled as left innominate vein). The left superior vena cava is not shown in this image. |
In anatomy, a persistent left superior vena cava is the most common variation of the thoracic venous system.[1][2] It is present in between 0.3% and 0.5% of the population,[3][4][5] and is an embryologic remnant that results from a failure to involute.
Presentation
In persistent left superior vena cava, the left brachiocephalic vein does not develop fully and the left upper limb and head and neck drain into the right atrium via the coronary sinus.[5]
In isolation, the variation is considered benign, but is very frequently associated with cardiac abnormalities (e.g. ventricular septal defect, atrioventricular septal defect) that have a significant mortality and morbidity.[4][6] It is more frequent in patients with congenital heart defects.[7]
The (right) superior vena cava is almost always unaffected by the presence of persistent left superior vena cava.[4][5]
Diagnosis
If an anomaly is detected during a routine ultrasound, a fetal echocardiogram is performed to determine whether a fetus has the condition.[8] Otherwise, it is often unnoticed unless an extenuating circumstance warrants further examination of the heart, usually much later in life.[citation needed]
CT and MRI scans in a parasagittal section may show a "pipe" sign where the left superior vena cava occurs.[4]
Treatment
If no other cardiac abnormalities are present, persistent left superior vena cava will not be treated, as it is usually asymptomatic and unharmful.[4] If it drains into the left atrium, then deoxygenated blood enters the circulation to the body, and cyanosis may occur.[8]
References
- ↑ "Persistent left superior vena cava: an intensivist's experience and review of the literature". South. Med. J. 96 (5): 528–9. May 2003. doi:10.1097/01.smj.0000060885.27846.91. PMID 12911199.
- ↑ "Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review". Clin Cardiol 27 (9): 515–8. September 2004. doi:10.1002/clc.4960270909. PMID 15471164.
- ↑ Angiography of Congenital Heart Disease. New York: Macmillan Publishing. 1984. http://www.learningradiology.com/archives03/COW%20061-Persistent%20Left%20SVC/leftsvccorrect.htm.
- ↑ 4.0 4.1 4.2 4.3 4.4 Crispi, Fatima; Martinez, Josep M. (2018-01-01), Copel, Joshua A.; D'Alton, Mary E.; Feltovich, Helen et al., eds., "92 - Anomalies of Systemic Venous Return" (in en), Obstetric Imaging: Fetal Diagnosis and Care (Second Edition) (Elsevier): pp. 411–414.e1, doi:10.1016/b978-0-323-44548-1.00092-9, ISBN 978-0-323-44548-1, http://www.sciencedirect.com/science/article/pii/B9780323445481000929, retrieved 2020-11-16
- ↑ 5.0 5.1 5.2 Fligner, Corinne L.; Clark, John I.; Clark, Judy M.; Larson, Lyle W.; Poole, Jeanne E. (2018-01-01), Poole, Jeanne E.; Larson, Lyle W., eds., "2 - Surgical Anatomy for the Implanting Physician" (in en), Surgical Implantation of Cardiac Rhythm Devices (Elsevier): pp. 13–58, doi:10.1016/b978-0-323-40126-5.00002-1, ISBN 978-0-323-40126-5, http://www.sciencedirect.com/science/article/pii/B9780323401265000021, retrieved 2020-11-16
- ↑ "Prenatal diagnosis of persistent left superior vena cava and its associated congenital anomalies". Ultrasound Obstet Gynecol 27 (3): 274–80. March 2006. doi:10.1002/uog.2704. PMID 16456841.
- ↑ "Persistent left superior vena cava. Incidence, associated congenital heart defects and frontal plane P-wave axis in a paediatric population with congenital heart disease". Acta Paediatr Scand 69 (1): 105–8. January 1980. doi:10.1111/j.1651-2227.1980.tb07039.x. PMID 7368902.
- ↑ 8.0 8.1 Marelli, Ariane J. (2012-01-01), Goldman, Lee; Schafer, Andrew I., eds., "69 - Congenital Heart Disease in Adults" (in en), Goldman's Cecil Medicine (Twenty Fourth Edition) (Philadelphia: W.B. Saunders): pp. 397–409, doi:10.1016/b978-1-4377-1604-7.00069-5, ISBN 978-1-4377-1604-7, http://www.sciencedirect.com/science/article/pii/B9781437716047000695, retrieved 2020-11-16
External links
| Classification |
|---|
 |  |
