open access

Vol 76, No 1 (2017)
Original article
Submitted: 2016-06-12
Accepted: 2016-07-18
Published online: 2016-08-22
Get Citation

Imaging topography and morphometry of persistent left superior caval vein and its variations, detected on cardiac implantable electronic device implantation

R. Steckiewicz, E. B. Świętoń, J. Czerniawska, P. Scisło, P. Stolarz
·
Pubmed: 27665950
·
Folia Morphol 2017;76(1):58-65.

open access

Vol 76, No 1 (2017)
ORIGINAL ARTICLES
Submitted: 2016-06-12
Accepted: 2016-07-18
Published online: 2016-08-22

Abstract

Background: Persistent left superior caval vein (PLSCV) is a rare, anatomically diverse developmental anomaly of systemic veins. Clinically asymptomatic PLSCVs are detected incidentally during medical procedures that utilise systemic veins, such as cardiac implantable electronic device (CIED) placement, and whose successful completion depends on favourable morphometric parameters of these vessels. The aim of this paper was to present topography and morphometry of PLSCV variations encountered during CIED implantation procedures.

Materials and methods: We analysed a group of 5,010 patients for detection of PLSCV during de-novo CIED implantation procedures with transvenous lead placement in the years 2003–2015. PLSCVs were detected intraprocedurally based on venographic images illustrating the venous anomaly and its morphometric parameters, and were subsequently confirmed via postoperative diagnostics.

Results: PLSCVs were detected in 10 patients (mean age 66.0 ± 14.0 years; 5 females and 5 males), who constituted 0.2% of the analysed group. There were 6 cases of double superior vena cava (DSVC), 3 of which had a brachiocephalic vein (BCV) connection and did not have BCV bridging. Four patients with a PLSCV had right superior vena cava agenesis; this very rare variation is known as ‘single PLSCV’. All of the detected PLSCV variations drained into the right atrium via the coronary sinus.

Conclusions: Our data from a period of 13 years illustrate how rare the PLSCV-type venous anomaly is. The three distinct anatomical PLSCV types showed inter-individual morphometric variations. Due to asymptomatic nature of this anomaly, all cases were detected incidentally, during CIED implantation procedures.

Abstract

Background: Persistent left superior caval vein (PLSCV) is a rare, anatomically diverse developmental anomaly of systemic veins. Clinically asymptomatic PLSCVs are detected incidentally during medical procedures that utilise systemic veins, such as cardiac implantable electronic device (CIED) placement, and whose successful completion depends on favourable morphometric parameters of these vessels. The aim of this paper was to present topography and morphometry of PLSCV variations encountered during CIED implantation procedures.

Materials and methods: We analysed a group of 5,010 patients for detection of PLSCV during de-novo CIED implantation procedures with transvenous lead placement in the years 2003–2015. PLSCVs were detected intraprocedurally based on venographic images illustrating the venous anomaly and its morphometric parameters, and were subsequently confirmed via postoperative diagnostics.

Results: PLSCVs were detected in 10 patients (mean age 66.0 ± 14.0 years; 5 females and 5 males), who constituted 0.2% of the analysed group. There were 6 cases of double superior vena cava (DSVC), 3 of which had a brachiocephalic vein (BCV) connection and did not have BCV bridging. Four patients with a PLSCV had right superior vena cava agenesis; this very rare variation is known as ‘single PLSCV’. All of the detected PLSCV variations drained into the right atrium via the coronary sinus.

Conclusions: Our data from a period of 13 years illustrate how rare the PLSCV-type venous anomaly is. The three distinct anatomical PLSCV types showed inter-individual morphometric variations. Due to asymptomatic nature of this anomaly, all cases were detected incidentally, during CIED implantation procedures.

Get Citation

Keywords

persistent left superior vena cava, venography, computed tomography, cardiac pacing, cardiac implantable electronic device

About this article
Title

Imaging topography and morphometry of persistent left superior caval vein and its variations, detected on cardiac implantable electronic device implantation

Journal

Folia Morphologica

Issue

Vol 76, No 1 (2017)

Article type

Original article

Pages

58-65

Published online

2016-08-22

Page views

1332

Article views/downloads

1672

DOI

10.5603/FM.a2016.0042

Pubmed

27665950

Bibliographic record

Folia Morphol 2017;76(1):58-65.

Keywords

persistent left superior vena cava
venography
computed tomography
cardiac pacing
cardiac implantable electronic device

Authors

R. Steckiewicz
E. B. Świętoń
J. Czerniawska
P. Scisło
P. Stolarz

References (28)
  1. Barceló A, De la Fuente LM, Stertzer SH. Anatomic and histologic rewiew of the coronary sinus. Int J Morphol. 2014; , 22(4): 331–338.
  2. Barrea C, Ovaert C, Moniotte S, et al. Prenatal diagnosis of abnormal cardinal systemic venous return without other heart defects: a case series. Prenat Diagn. 2011; 31(4): 380–388.
  3. Benz DC, Krasniqi N, Wagnetz U, et al. Isolated persistent left superior vena cava draining into the left atrium of an otherwise normal heart. Eur Heart J. 2013; 34(20): 1505.
  4. Biffi M, Bertini M, Ziacchi M, et al. Clinical implications of left superior vena cava persistence in candidates for pacemaker or cardioverter-defibrillator implantation. Heart Vessels. 2009; 24(2): 142–146.
  5. Burney K, Young H, Barnard SA, et al. CT appearances of congential and acquired abnormalities of the superior vena cava. Clin Radiol. 2007; 62(9): 837–842.
  6. da Silva AA, Silva ED, Segurado AV, et al. Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava. Rev Bras Anestesiol. 2009; 59(6): 751–755.
  7. Demos TC, Posniak HV, Pierce KL, et al. Venous anomalies of the thorax. AJR Am J Roentgenol. 2004; 182(5): 1139–1150.
  8. Dilaveris P, Sideris S, Stefanadis C. Pacing difficulties due to persistent left superior vena cava. Europace. 2011; 13(1): 2.
  9. Freeman AM, Fenster BE, Weinberger HD, et al. Hypoxia caused by persistent left superior vena cava connecting to the left atrium a rare clinical entity. Tex Heart Inst J. 2012; 39(5): 662–664.
  10. Fry Ac, Warwicker P. Bilateral superior vena cava. N Engl J Med. 2007; 356(18): 18.
  11. Fukuda Y, Yoshida T, Inage T, et al. Implantation of pacemaker for sick sinus syndrome in a patient with persistent left superior vena cava and absent right superior vena cava. Heart Vessels. 2008; 23(3): 206–208.
  12. 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.
  13. Gümüş A, Yildirim SV. Absent right superior vena cava with persistent left superior vena cava: two case reports. Turk J Pediatr. 2012; 54(5): 545–547.
  14. 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.
  15. Kawashima T, Sato K, Sato F, et al. An anatomical study of the human cardiac veins with special reference to the drainage of the great cardiac vein. Ann Anat. 2003; 185(6): 535–542.
  16. Kilickap M, Altin T, Akyurek O, et al. DDD pacemaker implantation in a patient with persistent left superior vena cava and absent right superior vena cava: a four-year follow-up report. Can J Cardiol. 2005; 21(13): 1221–1223.
  17. Kowalski M, Maynard R, Ananthasubramaniam K. Imaging of persistent left sided superior vena cava with echocardiography and multi-slice computed tomography: implications for daily practice. Cardiol J. 2011; 18(3): 332–336.
  18. Kula S, Cevik A, Sanli C, et al. Persistent left superior vena cava: experience of a tertiary health-care center. Pediatr Int. 2011; 53(6): 1066–1069.
  19. Larsen AI, Nilsen DW. Persistent left superior vena cava. Use of an innominate vein between left and right superior caval veins for the placement of a right ventricular lead during ICD/CRT implantation. Eur Heart J. 2005; 26(20): 2178.
  20. Nsah EN, Moore GW, Hutchins GM. Pathogenesis of persistent left superior vena cava with a coronary sinus connection. Pediatr Pathol. 1991; 11(2): 261–269.
  21. Peltier J, Destrieux C, Desme J, et al. The persistent left superior vena cava: anatomical study, pathogenesis and clinical considerations. Surg Radiol Anat. 2006; 28(2): 206–210.
  22. Povoski SP, Khabiri H. Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011; 9: 173.
  23. Ratliff HL, Yousufuddin M, Lieving WR, et al. Persistent left superior vena cava: case reports and clinical implications. Int J Cardiol. 2006; 113(2): 242–246.
  24. Sanchez Mejia A, Singh H, Bhalla S, et al. Chronic cyanosis due to persistent left superior vena cava draining into the left atrium in the absence of a coronary sinus. Pediatr Cardiol. 2013; 34(6): 1514–1516.
  25. Serafi AS. Discovering persistent left superior vena cava (PLSVC) during Pacemaker implantation. Life Sci J. 2013; 10: 1198–1201.
  26. Szymczyk K, Polguj M, Szymczyk E, et al. Persistent left superior vena cava with an absent right superior vena cava in a 72-year-old male with multivessel coronary artery disease. Folia Morphol. 2013; 72(3): 271–273, doi: 10.5603/fm.2013.0044, indexed in Pubmed: 24068691.
  27. Whitten CR, Khan S, Munneke GJ, et al. A diagnostic approach to mediastinal abnormalities. Radiographics. 2007; 27(3): 657–671.
  28. Yonekura H, Kanazawa S, Miyawaki I, et al. Partially unroofed coronary sinus with persistent left superior vena cava: the utility of two and three-dimensional transesophageal echocardiography: a case report. Korean J Anesthesiol. 2014; 67(1): 52–56.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl