open access

Vol 77, No 1 (2018)
Case report
Submitted: 2017-06-04
Accepted: 2017-06-21
Published online: 2017-07-06
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A rare vascular anomaly in the form of double left brachiocephalic vein detected incidentally during cardiac implantable electronic device (CIED) placement

R. Steckiewicz, E. B. Świętoń, P. Stolarz
·
Pubmed: 28703852
·
Folia Morphol 2018;77(1):161-165.

open access

Vol 77, No 1 (2018)
CASE REPORTS
Submitted: 2017-06-04
Accepted: 2017-06-21
Published online: 2017-07-06

Abstract

The growing number of transvenous cardiac implantable electronic device (CIED) implantation procedures helps detect rare vascular anomalies. Genetic disturbances in vascular development can produce systemic vein anomalies, including the left brachiocephalic vein (BCV). BCV anomalies commonly coexist with a persistent left superior vena cava (PLSVC), detected in 0.3–0.5% of the general population. The three known anatomical variations of PLSVC are two variations involving a BCV bridge and the third with BCV agenesis. BCV anomalies occur in 1% of patients with congenital heart defects, whereas the estimated proportion of BCV anomalies in the population with no cardiovascular symptoms is below 0.4%. A rarely observed, and thus rarely reported, BCV variation is a double left BCV, with the additional vessel typically found inferior and posterior to the ascending aorta prior to draining into the superior vena cava. This case report presents a previously unreported variation of double left BCV, with both vessels coursing parallel to each other, superior to the aortic arch. (Folia Morphol 2018; 77, 1: 161–165)

Abstract

The growing number of transvenous cardiac implantable electronic device (CIED) implantation procedures helps detect rare vascular anomalies. Genetic disturbances in vascular development can produce systemic vein anomalies, including the left brachiocephalic vein (BCV). BCV anomalies commonly coexist with a persistent left superior vena cava (PLSVC), detected in 0.3–0.5% of the general population. The three known anatomical variations of PLSVC are two variations involving a BCV bridge and the third with BCV agenesis. BCV anomalies occur in 1% of patients with congenital heart defects, whereas the estimated proportion of BCV anomalies in the population with no cardiovascular symptoms is below 0.4%. A rarely observed, and thus rarely reported, BCV variation is a double left BCV, with the additional vessel typically found inferior and posterior to the ascending aorta prior to draining into the superior vena cava. This case report presents a previously unreported variation of double left BCV, with both vessels coursing parallel to each other, superior to the aortic arch. (Folia Morphol 2018; 77, 1: 161–165)

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Keywords

double left brachiocephalic vein, venography, computed tomography, cardiac pacing

About this article
Title

A rare vascular anomaly in the form of double left brachiocephalic vein detected incidentally during cardiac implantable electronic device (CIED) placement

Journal

Folia Morphologica

Issue

Vol 77, No 1 (2018)

Article type

Case report

Pages

161-165

Published online

2017-07-06

Page views

1263

Article views/downloads

1189

DOI

10.5603/FM.a2017.0065

Pubmed

28703852

Bibliographic record

Folia Morphol 2018;77(1):161-165.

Keywords

double left brachiocephalic vein
venography
computed tomography
cardiac pacing

Authors

R. Steckiewicz
E. B. Świętoń
P. Stolarz

References (18)
  1. Chen SJ, Liu KL, Chen HY, et al. Anomalous brachiocephalic vein: CT, embryology, and clinical implications. AJR Am J Roentgenol. 2005; 184(4): 1235–1240.
  2. Chern MS, Ko JS, Tsai A, et al. Aberrant left brachiocephalic vein: CT imaging findings and embryologic correlation. Eur Radiol. 1999; 9(9): 1835–1839.
  3. Corno AF, Alahdal SA, Das KM. Systemic venous anomalies in the Middle East. Front Pediatr. 2013; 1: 1.
  4. 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.
  5. Gülsün M, Gökoğlu A, Ariyürek M, et al. Subaortic left brachiocephalic vein: computed tomography and magnetic resonance angiography findings. Surg Radiol Anat. 2003; 25(3-4): 335–338.
  6. Hindricks G, Camm J, Merkely B, et al. The EHRA White Book. 2016: 375–384.
  7. 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.
  8. Kawamura I, Hojo R, Fukamizu S. A case of pacemaker implantation in the patient with duplication of the left innominate vein: a case report. Springerplus. 2016; 5: 515.
  9. 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.
  10. Ko SF, Huang CC, Ng SH, et al. Imaging of the brachiocephalic vein. AJR Am J Roentgenol. 2008; 191(3): 897–907.
  11. Kondrachuk O, Yalynska T, Tammo R. Double left brachiocephalic vein. Pediatr Cardiol. 2013; 34(3): 767–768.
  12. Kulkarni S, Jain S, Kasar P, et al. Retroaortic left innominate vein - Incidence, association with congenital heart defects, embryology, and clinical significance. Ann Pediatr Cardiol. 2008; 1(2): 139–141.
  13. Kwon O, Lim J, Lee J, et al. Double left brachiocephalic veins with persistent left superior vena cava: a case report. J Korean Society Radiol. 2014; 71(2): 55.
  14. Nagashima M, Shikata F, Okamura T, et al. Anomalous subaortic left brachiocephalic vein in surgical cases and literature review. Clin Anat. 2010; 23(8): 950–955.
  15. 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.
  16. 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.
  17. Takada Y, Narimatsu A, Kohno A, et al. Anomalous left brachiocephalic vein: CT findings. J Comput Assist Tomogr. 1992; 16(6): 893–896.
  18. Topcuoglu OM, Atceken Z, Ariyurek OM. Circumaortic doubled left brachiocephalic vein: a rare confusing variation. Surg Radiol Anat. 2015; 37(3): 315–318.

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