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Open Access Highly Accessed Case report

Persistent left superior vena cava: a case report and review of literature

Sandeep K Goyal1, Sujeeth R Punnam4, Gita Verma5 and Frederick L Ruberg23*

Author Affiliations

1 Department of Medicine, Boston University School of Medicine, Boston, MA, USA

2 Department of Medicine, Section of Cardiology, Boston University School of Medicine, Boston, MA, USA

3 Department of Radiology, Boston University School of Medicine, Boston, MA, USA

4 Division of Cardiology, Michigan State University, East Lansing, MI, USA

5 Maulana Azad Medical College, New Delhi, India

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Cardiovascular Ultrasound 2008, 6:50  doi:10.1186/1476-7120-6-50

Published: 10 October 2008

Abstract

Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress. It is most commonly observed in isolation but can be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. The presence of PLSVC can render access to the right side of heart challenging via the left subclavian approach, which is a common site of access utilized when placing pacemakers and Swan-Ganz catheters. Incidental notation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography.