Giant coronary sinus and absent right superior vena cava

Area of Science:

• Cardiovascular Imaging
• Thoracic Venous Anomalies
• Congenital Heart Disease

Background:

• Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly, found in 0.3% of the general population and 10% of patients with congenital heart disease.
• Diagnosis is often incidental during cardiovascular imaging or surgery.
• While usually hemodynamically insignificant, PLSVC can complicate central venous catheterization, pacemaker implantation, and cardiopulmonary bypass.

Observation:

• Approximately 20% of PLSVC cases are associated with an absent right superior vena cava.
• In such cases, the coronary sinus can enlarge significantly due to excessive blood flow.

Findings:

• This report details a case of PLSVC with the rare complication of an absent right superior vena cava.
• The absence of the right SVC resulted in a markedly enlarged (giant) coronary sinus.

Implications:

• Awareness of PLSVC and its association with absent right SVC is crucial for managing potential complications during medical procedures.
• Understanding this anomaly aids in interpreting cardiovascular imaging findings and managing patients with congenital heart disease.