Single Persistent Left Superior Vena Cava Draining Into the Left Atrium Causing Neonatal Cyanosis: A Case Report.

Area of Science:

• Cardiology
• Pediatric Surgery
• Neonatology

Background:

• Persistence of the left superior vena cava (PLSVC) is a common systemic venous drainage variant.
• Typically, PLSVC drains into the right atrium without complications.
• However, drainage into the left atrium bypasses pulmonary circulation, causing cyanosis.

Purpose of the Study:

• To report a case of a neonate with severe hypoxemia due to a single PLSVC draining into the left atrium.
• To discuss the diagnostic and therapeutic challenges of this rare condition.

Main Methods:

• Echocardiography identified a single PLSVC draining directly into the left atrium.
• The neonate received respiratory support and nitric oxide therapy without improvement.
• Interventions included atrial septostomy and corrective surgery to redirect PLSVC flow.

Main Results:

• The neonate presented with severe hypoxemia unresponsive to conventional treatment.
• Post-surgical follow-up at 11 months showed the patient was asymptomatic with normal oxygen saturation.
• Echocardiography confirmed normal cardiac function and venous drainage.

Conclusions:

• A single PLSVC draining into the left atrium is a rare but critical cause of neonatal cyanosis.
• This condition should be considered in neonates with refractory hypoxemia.
• Surgical correction offers a successful treatment option for this anomaly.