Open AccessPersistent left superior vena cava identified by transesophageal echocardiography
Author(s) -
Sofia A. Horvath,
Nicholas Suraci,
Jayanand D'Mello,
Orlando Santana
Publication year - 2019
Publication title -
reviews in cardiovascular medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.555
H-Index - 39
eISSN - 2153-8174
pISSN - 1530-6550
DOI - 10.31083/j.rcm.2019.02.510
Subject(s) - medicine , persistent left superior vena cava , coronary sinus , superior vena cava , asymptomatic , cardiology , catheter , central venous catheter , stenosis , radiology , surgery
A 70-year-old female with severe aortic stenosis presented for aortic valve replacement and underwent routine preoperative Swan-Ganz catheter placement. Transesophageal echocardiography demonstrated a dilated coronary sinus with a catheter present. A high suspicion of venous anomaly prompted an agitated saline study. Flow through the coronary sinus into the right atrium was observed, confirming the presence of a persistent left superior vena cava. Although the persistent left superior vena cava has a low prevalence in the general population, it is one of the most common thoracic venous anomalies. During central venous cannulation, the presence of venous anomalies increases procedural complication rates. Fortunately, our patient remained asymptomatic both before and after catheter insertion. Awareness of this anomaly could help clinicians avoid complications.