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Persistent left superior vena cava with absent right superior vena cava in adults: CT and clinical findings

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Abstract

Purpose

Persistent left superior vena cava (PLSVC) with absent right superior vena cava (ARSVC) is rare. We evaluated CT and clinical findings of adults with ARSVC.

Materials and methods

Our study included 11 adults with ARSVC (mean age, 63 ± 17 years). We evaluated CT findings of the azygos vein system and coronary sinus (CS) using thin slice data of > 64 MDCT. Arrhythmia and congenial heart disease were assessed. We compared the CS diameters between the ARSVC group and the control group of 120 adults with normal vena cava (mean age, 60 ± 4 years).

Results

Adults with ARSVC had no azygos vein arch and the hemiazygos vein continued to PLSVCs via the superior intercostal vein. Eight adults had arrhythmia including conduction disturbance and one arrhythmia was associated with atrial septal defect. All adults with ARSVC had dilated CS larger than 11 mm. The mean diameter of the CS in the ARSVC group was 18.4 mm, and that of the control group was 6.8 mm. CS diameter in the ARSVC group was larger than that in the control group (p < 0.001).

Conclusion

Adults with ARSVC had dilated CS and no azygos vein arch. Four adults had conduction disturbance.

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References

  1. Minniti S, Visentini S, Procacci C. Congenital anomalies of the venae cavae: embryological origin, imaging features and report of three new variants. Eur Radiol. 2002;2(8):2040–55.

    Article  Google Scholar 

  2. Ratliff HL, Yousufuddin M, Lieving WR, Watson BE, Malas A, Rosencrance G, et al. Persistent left superior vena cava: case reports and clinical implications. Int J Cardiol. 2006;113(2):242–6.

    Article  PubMed  Google Scholar 

  3. Kula S, Cevik A, Sanli C, Pektas A, Tunaoglu FS, Oguz AD, et al. Persistent left superior vena cava: experience of a tertiary health-care center. Pediatr Int. 2011;53(2):1066–9.

    Article  PubMed  Google Scholar 

  4. Biffi M, Bertini M, Ziacchi M, Martignani C, Valzania C, Diemberger I, et al. Clinical implications of left superior vena cava persistence in candidates for pacemaker or cardioverter–defibrillator implantation. Heart Vessel. 2009;24(2):142–6.

    Article  Google Scholar 

  5. 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;2:249–52.

    PubMed  PubMed Central  Google Scholar 

  6. Irlich TN, Herzer JA, Schulte HD. Left persisting, singular superior vena cava and pacemaker electrode implantation by right cephalic vein. Z Kardiol. 1976;65(6):575–82.

    CAS  PubMed  Google Scholar 

  7. Lenox CC, Hashida Y, Anderson RH, Hubbard JD. Conduction tissue anomalies in absence of the right superior caval vein. Int J Cardiol. 1985;8(3):251–60.

    Article  CAS  PubMed  Google Scholar 

  8. Bartram U, Van Praagh S, Levine JC, Hines M, Bensky AS, Van Praagh R. Absent right superior vena cava in visceroatrial situs solitus. Am J Cardiol. 1997;8(2):175–83.

    Article  Google Scholar 

  9. Uçar O, Paşaoğlu L, Ciçekçioğlu H, Vural M, Kocaoğlu I, Aydoğdu S. Persistent left superior vena cava with absent right superior vena cava: a case report and review of the literature. Cardiovasc J Afr. 2010;21(3):164–6.

    PubMed  PubMed Central  Google Scholar 

  10. 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(5):674–9.

    Article  PubMed  Google Scholar 

  11. Bisoyi S, Jagannathan U, Dash AK, Tripathy S, Mohapatra R, Pattnaik NK, et al. Isolated persistent left superior vena cava: A case report and its clinical implications. Ann Card Anaesth. 2017;20(1):104–7.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Uemura M, Suwa F, Takemura A, Toda I, Morishita A. Classification of persistent left superior vena cava considering presence and development of both superior venae cavae, the anastomotic ramus between superior venae cavae, and the azygos venous system. Anat Sci Int. 2012;87(1):212–22.

    Article  PubMed  Google Scholar 

  13. Recupero A, Pugliatti P, Rizzo F, Carerj S, Cavalli G, de Gregorio C, et al. Persistent left-sided superior vena cava: integrated noninvasive diagnosis. Echocardiography. 2007;24(9):982–6.

    Article  PubMed  Google Scholar 

  14. Gonzalez-Juanatey C, Testa A, Vidan J, Izquierdo R, Garcia-Ctelo A, Daniel C, et al. Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review. Clin Cardiol. 2004;27(9):515–8.

    Article  PubMed  Google Scholar 

  15. Isaacs D, Hazany S, Gamst A, Stark P, Mahmud E. Evaluation of the coronary sinus on chest computed tomography in patients with and without pulmonary artery hypertension. J Comput Assist Tomo. 2009;33(4):513–6.

    Article  Google Scholar 

  16. Girerd A, Gressard A, Berthezene Y, Lantelme P. Persistent left superior vena cava with absent right superior vena cava: a difficult cardiac pacemaker implantation. Inter J Cardiol. 2009;132(3):e117–e11919.

    Article  CAS  Google Scholar 

  17. Zhang T, Wang J, Ming T, Shang L-H. Pacemaker implantation in a patient with paroxysmal atrial fibrillation and persistent left superior vena cava with absent right superior vena cava. Chin Med J. 2017;130(16):2005–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Shah SS, Teague SD, Lu JC, Dorfman AL, Kazerooni EA, Agarwal PP. Imaging of the coronary sinus: normal anatomy and congenital abnormalities. Radiographics. 2012;32(4):991–1008.

    Article  PubMed  Google Scholar 

  19. Chen YA. Computed tomography and magnetic resonance imaging of the coronary sinus: anatomic variants and congenital anomalies. Insight Imaging. 2014;5(5):547–57.

    Article  Google Scholar 

  20. Arslan G, Cubuk M, Ozkaynak C, Sindel T, Lüleci E. Absence of the azygos vein. Clin Imaging. 2000;24(3):157–8.

    Article  CAS  PubMed  Google Scholar 

  21. Kolski BC, Khadivi B, Anawati M, Daniels LB, Demaria AN, Blanchard DG. The dilated coronary sinus: utility of coronary sinus cross-sectional area and eccentricity index in differentiating right atrial pressure overload from persistent left superior vena cava. Echocardiography. 2011;28(8):829–32.

    Article  PubMed  Google Scholar 

  22. Ouchi K, Sakuma T, Kawai M, Fukuda K. Incidence and appearances of coronary sinus anomalies in adults on cardiac CT. Jpn J Radiol. 2016;34(10):684–90.

    Article  PubMed  Google Scholar 

  23. Gunes Y, Guntekin U, Tuncer M, Kaya Y, Akyol A. Association of coronary sinus diameter with pulmonary hypertension. Echocardiography. 2008;25(9):935–40.

    Article  PubMed  Google Scholar 

  24. Chan KL, Abdulla A. Images in cardiology. Giant coronary sinus and absent right superior vena cava. Heart. 2000;83(6):704.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Camm AJ, Dymond D, Spurrell RA. Sinus node dysfunction associated with absence of right superior vena cava. Br Heart J. 1979;41(4):504–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Mori T. Cardiac arrhythmias in the elderly. Jpn J Geriat. 2016;65(2):136–40 (in Japanese).

    Google Scholar 

  27. Arata H, Fujiwara T, Saito H, Hayakawa H, Okumura H. Ferequency of cardiac arrtythmias and age-related changes in a general hospital-report from Inada-Noborito Hospital in 1983. Jpn J Geriat. 1986;23(1):41–9 (in Japanese).

    Article  Google Scholar 

  28. Yamamuro H, Ichikawa T, Hashimoto J, Ono S, Nagata Y, Kawada S, et al. Congenital anomalies of the left brachiocephalic vein detected in adults on computed tomography. Jpn J Radiol. 2017;35(10):597–605.

    Article  CAS  PubMed  Google Scholar 

  29. Kobayashi M, Ichikawa T, Koizumi J, Hashimoto J, Yamamuro H, Hara T, et al. Aberrant left brachiocephalic vein versus persistent left superior vena cava without bridging vein in adults: evaluation on computed tomography. Ann Vasc Dis. 2018;11(4):535–41.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors thank Mr. Yamaguchi T, Mr. Suzuki M, Mr. Kasahara T, and Dr. Ono S for their technical assistance.

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Authors and Affiliations

  1. Department of Radiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan

    Tamaki Ichikawa, Takuya Hara, Jun Koizumi, Noriko Nakamura, Yui Nagafuji & Jun Hashimoto

  2. Basic Clinical Science and Public Health, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan

    Hiroyuki Furuya

  3. Department of Radiation Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan

    Tatsuya Mikami & Toshihisa Kuroki

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  1. Tamaki Ichikawa
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  2. Takuya Hara
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Correspondence to Tamaki Ichikawa.

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Ichikawa, T., Hara, T., Koizumi, J. et al. Persistent left superior vena cava with absent right superior vena cava in adults: CT and clinical findings. Jpn J Radiol 38, 1046–1051 (2020). https://doi.org/10.1007/s11604-020-01013-4

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  • DOI: https://doi.org/10.1007/s11604-020-01013-4

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