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Absent right and persistent left superior vena cava
Tom Vydt1, Frank Cools, Frank E Rademakers
1AZ KLINA, Department of Cardiology, Brasschaat, Belgium.
Insights
A rare congenital anomaly, the absence of the right superior vena cava alongside a persistent left superior vena cava, was identified in a patient with atrial fibrillation. This case highlights the importance of diagnosing venous anomalies.
Area of Science:
- Cardiology
- Anatomy
- Medical Imaging
Background:
- Congenital venous anomalies, such as persistent left superior vena cava (PLSVC), are relatively common.
- The simultaneous complete absence of the right superior vena cava (RSVC) is a rare occurrence.
Observation:
- A patient presented with atrial fibrillation and a dilated coronary sinus.
- Diagnostic imaging revealed a persistent left superior vena cava.
- Contrast injection and phlebography confirmed the absence of the right superior vena cava.
Findings:
- The primary finding was the rare co-occurrence of PLSVC and complete RSVC absence.
- No other cardiac anomalies were identified in the patient.
- The dilated coronary sinus was a consequence of the venous anomaly.
Implications:
- This case underscores the diagnostic importance of recognizing rare venous anomalies.
- Understanding the embryology and presentation of such anomalies is crucial for clinical practice.
- Accurate diagnosis can prevent misinterpretation of imaging findings and guide patient management.
Abstract:
A patient is described presenting with atrial fibrillation. A dilated coronary sinus was found due to the presence of a persistent left superior caval vein. Absence of the right superior caval vein was suspected with contrast injection through an i.v. line in the right arm, and was confirmed with phlebography. No associated cardiac anomalies were found. Persistent left superior vena cava is a common anomaly, although simultaneous complete absence of the right superior vena cava is rare. The incidence, embryology, diagnosis and importance of this anomaly is discussed.
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