Cardioverter defibrillator implantation in a patient with absent right superior vena cava

Area of Science:

• Cardiovascular medicine
• Thoracic surgery
• Medical imaging

Background:

• Left-sided superior vena cava (LSVC) is the most frequent congenital thoracic venous anomaly.
• Absence of the right superior vena cava (RSVC) is an exceptionally rare venous anomaly.
• Anatomical variations in the superior vena cava can impact medical procedures.

Purpose of the Study:

• To report a rare case of absent right superior vena cava (RSVC) in a patient.
• To describe the clinical presentation and management of this rare venous anomaly.
• To emphasize the importance of recognizing venous anomalies during device implantation.

Main Methods:

• Case report of a patient presenting for cardioverter defibrillator (ICD) implantation.
• Review of diagnostic imaging to identify the venous anomaly.
• Surgical planning considering the anatomical variation.

Main Results:

• The patient was found to have an absent right superior vena cava (RSVC).
• The left-sided superior vena cava (LSVC) was present, consistent with common anomalies.
• Successful implantation of the cardioverter defibrillator (ICD) was performed despite the venous anomaly.

Conclusions:

• The absence of RSVC, though rare, must be considered in the differential diagnosis of thoracic venous anomalies.
• Awareness of such anomalies is crucial for safe and effective cardiovascular device implantation.
• This case underscores the variability of thoracic venous anatomy and its clinical implications.