open access
Double superior vena cava and left brachiocephalic vein agenesis: a rare systemic vein anomaly and potential source of cardiac implantable electronic device and central venous catheter placement complications
, 2, 2, 2, 3, 2, 2, 3, 2
Affiliations- Department of Cardiology, Central University Hospital in Warsaw, Poland
- 1st Department of Cardiology, Medical University of Warsaw, Poland
- 2nd Department of Radiology Medical University of Warsaw, Poland
open access
Abstract
Abnormal systemic vein development produces anomalous veins, which — in the case of persistent left superior vena cava and/or left brachiocephalic vein — exhibit considerable topographic and morphometric differences in comparison with their usual anatomy. The nature and extent of those developmental anomalies — detected during intravenous procedures, such as cardiac implantable electronic device (CIED) lead insertion or central venous catheter placement — may hinder the procedure itself and/or adversely affect its outcome, both at the stage of cardiac lead advancement through an abnormally shaped vessel and lead positioning within the heart. This may lead to problems in achieving optimal sensing and pacing parameters and in ensuring that the patient cannot feel the pacing impulses. These events accompanied a de novo CIED implantation procedure in the patient with a double superior vena cava and left brachiocephalic vein agenesis, who ultimately required reoperation.
Abstract
Abnormal systemic vein development produces anomalous veins, which — in the case of persistent left superior vena cava and/or left brachiocephalic vein — exhibit considerable topographic and morphometric differences in comparison with their usual anatomy. The nature and extent of those developmental anomalies — detected during intravenous procedures, such as cardiac implantable electronic device (CIED) lead insertion or central venous catheter placement — may hinder the procedure itself and/or adversely affect its outcome, both at the stage of cardiac lead advancement through an abnormally shaped vessel and lead positioning within the heart. This may lead to problems in achieving optimal sensing and pacing parameters and in ensuring that the patient cannot feel the pacing impulses. These events accompanied a de novo CIED implantation procedure in the patient with a double superior vena cava and left brachiocephalic vein agenesis, who ultimately required reoperation.
Keywords
persistent left superior vena cava, brachiocephalic vein, venous anomalies, venography, transthoracic echocardiogram, cardiac implantable electronic device (CIED), central venous catheter (CVC)
About this articleTitle
Double superior vena cava and left brachiocephalic vein agenesis: a rare systemic vein anomaly and potential source of cardiac implantable electronic device and central venous catheter placement complications
Journal
Issue
Article type
Case report
Pages
1066-1071
Published online
2021-10-21
Page views
4091
Article views/downloads
517
DOI
Pubmed
Bibliographic record
Folia Morphol 2022;81(4):1066-1071.
Keywords
persistent left superior vena cava
brachiocephalic vein
venous anomalies
venography
transthoracic echocardiogram
cardiac implantable electronic device (CIED)
central venous catheter (CVC)
Authors
R. Steckiewicz
P. Stolarz
M. Marchel
M. Michalak
D. Konecki
E. Szczerba
M. Kowara
L. Grabowska-Derlatka
M. Grabowski
References (19)- Azizova A, Onder O, Arslan S, et al. Persistent left superior vena cava: clinical importance and differential diagnoses. Insights Imaging. 2020; 11(1): 110.
- Biffi M, Boriani G, Frabetti L, et al. Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10-year experience. Chest. 2001; 120(1): 139–144.
- Chen SJ, Liu KL, Chen HY, et al. Anomalous brachiocephalic vein: CT, embryology, and clinical implications. Am J Roentgenol. 2005; 184(4): 1235–1240.
- Ghadiali N, Teo LM, Sheah K. Bedside confirmation of a persistent left superior vena cava based on aberrantly positioned central venous catheter on chest radiograph. Br J Anaesth. 2006; 96(1): 53–56.
- Gibelli G, Biasi S. Persistent left superior vena cava and absent right superior vena cava: not only an anatomic variant. J Cardiovasc Echogr. 2013; 23(1): 42–44.
- Heye T, Wengenroth M, Schipp A, et al. Persistent left superior vena cava with absent right superior vena cava: morphological CT features and clinical implications. Int J Cardiol. 2007; 116(3): e103–e105.
- Hsu LF, Jaïs P, Keane D, et al. Atrial fibrillation originating from persistent left superior vena cava. Circulation. 2004; 109(7): 828–832.
- Kahkouee S, Sadr M, Pedarzadeh E, et al. Anomalous left brachiocephalic vein: important vascular anomaly concomitant with congenital anomalies and heart diseases. Folia Morphol. 2017; 76(1): 51–57.
- Kobayashi M, Ichikawa T, Koizumi J, 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): 535–541.
- Kurtoglu E, Cakin O, Akcay S, et al. Persistent left superior vena cava draining into the coronary sinus: a case report. Cardiol Res. 2011; 2(5): 249–252.
- Nagasawa H, Kuwabara N, Goto H, et al. Incidence of persistent left superior vena cava in the normal population and in patients with congenital heart diseases detected using echocardiography. Pediatr Cardiol. 2017; 39(3): 484–490.
- Perles Z, Nir A, Gavri S, et al. Prevalence of persistent superior vena cava and association with congenital heart anomalies. Am J Cardiol. 2013; 112(8): 1214–1218.
- Postema PG, Rammeloo LAJ, van Litsenburg R, et al. Left superior vena cava in pediatric cardiology associated with extra-cardiac anomalies. Int J Cardiol. 2008; 123(3): 302–306.
- Rigatelli G. Congenitally persistent left superior vena cava: a possible unpleasant problem during invasive procedures. J Cardiovasc Med (Hagerstown). 2007; 8(7): 483–487.
- 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): 674–679.
- Steckiewicz R, Kosior DA, Rosiak M, et al. The prevalence of superior vena cava anomalies as detected in cardiac implantable electronic device recipients at a tertiary cardiology centre over a 12-year period. Hellenic J Cardiol. 2016; 57(2): 101–106.
- Turagam MK, Atoui M, Atkins D, et al. Persistent left superior vena cava as an arrhythmogenic source in atrial fibrillation: results from a multicenter experience. J Interv Card Electrophysiol. 2019; 54(2): 93–100.
- Tyrak KW, Holda J, Holda MK, et al. Persistent left superior vena cava. Cardiovasc J Afr. 2017; 28(3): e1–e4.
- Vertemati M, Rizzetto F, Cassin S, et al. Clinical relevance of the left brachiocephalic vein anatomy for vascular access in dialysis patients. Clin Anat. 2020; 33(8): 1120–1129.
