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Persistent left superior vena cava and associated structural and functional considerations

P C Bunger, D A Neufeld, J C Moore

    Angiology
    |September 1, 1981
    PubMed
    Summary
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    This study highlights potential links between unusual systemic venous return, such as a left superior vena cava, and atrial fibrillation in an elderly patient. These venous anomalies may contribute to unexplained arrhythmias, warranting coronary sinus assessment.

    Area of Science:

    • Cardiology
    • Vascular Anatomy
    • Electrophysiology

    Background:

    • Systemic venous return anomalies can present complex clinical scenarios.
    • Atrial fibrillation is a common arrhythmia with multifactorial causes.
    • Cor triatriatum is a rare congenital heart defect affecting atrial septation.

    Observation:

    • An elderly woman presented with a rare combination of anomalous systemic venous return.
    • The anomalies included a left superior vena cava and a persistent left hepatic vein draining into the coronary sinus.
    • A forme fruste of cor triatriatum was also noted in the absence of other structural or functional deficits.

    Findings:

    • A potentially significant association was identified between these systemic venous anomalies and a history of atrial fibrillation.

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  • The specific combination of bilateral superior venae cavae and a persistent left hepatic vein draining into the coronary sinus is rare.
  • The absence of other cardiac defects made it challenging to determine the exact prevalence of these anomalies.

    • Implications:

    • Systemic venous anomalies, particularly those involving the coronary sinus, should be considered in patients with unexplained arrhythmias.
    • Assessment of coronary sinus size is recommended for patients presenting with atrial fibrillation.
    • Understanding these rare anatomical variations is crucial for accurate diagnosis and management of cardiac arrhythmias.