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Occlusion of persistent left superior vena cava to unroofed coronary sinus using vena cava filter and coils

J T Heng1, J V De Giovanni

  • 1Heart Unit, Birmingham Children's Hospital, NHS Trust, United Kingdom.

Insights

A persistent left superior vena cava caused cyanosis in a patient with complex heart disease. Occluding this vessel with a vena cava filter successfully treated the condition.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Medical Device Technology

Background:

  • Complex cyanotic heart disease and pulmonary hypertension can lead to significant patient morbidity.
  • A persistent left superior vena cava (PLSVC) draining into an unroofed coronary sinus is a rare anomaly that can cause cyanosis.
  • Accurate diagnosis and effective intervention are crucial for managing such complex cardiac conditions.

Observation:

  • A 48-year-old female presented with partial cyanosis attributed to a PLSVC.
  • The PLSVC measured 22 mm in diameter and drained into an unroofed coronary sinus.
  • This anatomical variation resulted in right-to-left shunting, exacerbating her cyanotic heart disease.

Findings:

  • The PLSVC was successfully occluded using a Günther Tulip Vena Cava Mreye Filter.
  • The filter served as a barrier, enabling the effective use of embolisation coils to close the anomalous vessel.
  • This percutaneous intervention resolved the abnormal venous drainage and corrected the cyanosis.

Implications:

  • Percutaneous occlusion of PLSVC using vena cava filters is a viable treatment option.
  • This approach offers a minimally invasive alternative for managing cyanosis caused by anomalous venous connections.
  • Successful intervention can significantly improve the quality of life for patients with complex congenital heart disease and rare venous anomalies.

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