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Anomalous atrium associated with persistent left superior vena cava


Persistent left superior vena cava (PLSVC) is the most common venous anomaly with an incidence of 0.3–0.5% in the general population. Here, we report a rare case of PLSVC with anomalous atrium in a cadaver during the student′s dissection session at the University of Tsukuba. In this case, the coronary sinus had merged with the right atrium to form an enlarged sac-like structure and received systemic venous flow including inflow from the PLSVC. The roof of the coronary sinus with the right atrium was thicker than that of the control cases. We further found that the distance between the sinoatrial node and the opening of the coronary sinus was slightly more than half of that in control cases. This variant appears interesting and is worth reporting for developmental and clinical consideration.

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  • Biffi M, Boriani G, Frabetti L, Bronzetti G, Branzi A (2001) Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10-year experience. Chest 120:139–144

    CAS  Article  Google Scholar 

  • Faber JW, Boukens BJ, Oostra R-J, Moorman AFM, Christoffels VM, Jensen B (2019) Sinus venosus incorporation: contentious issues and operational criteria for developmental and evolutionary studies. J Anat 234:583–591

    Article  Google Scholar 

  • Furuki H, Matsutani T, Hagiwara N, Nomura T, Uchida E (2015) A case of esophageal cancer in a patient with persistent left and absent right superior vena cava. Nihon Rinsho Geka Gakkai Zasshi 76:2422–2426 (in Japanese with English summary)

    Article  Google Scholar 

  • Ghadiali N, Teo LM, Sheah K (2006) Bedside confirmation of a persistent left superior vena cava based on aberrantly positioned central venous catheter on chest radiograph. Br J Anaesth 96:53–56

    CAS  Article  Google Scholar 

  • Inoue S, Makino M, Ota H, Sakai T, Saito T, Kobayashi Y, Ogawa G, Matsuyama T (2010) Anatomical construction of atrium and pulmonary veins and their arrhythmogenicity—from the histopathological viewpoint. Jpn J Electrocardiol 30:268–274 (in Japanese)

    Article  Google Scholar 

  • Lancaster JF, Leonard JJ, Leon DF, Kroetz FW, Shaver JA (1965) The experimental production of coronary sinus rhythm in man. Am Heart J 70:89–93

    CAS  Article  Google Scholar 

  • Makino M, Inoue S, Matsuyama T, Sakai T, Kobayashi Y, Katagiri T, Ota H (2006) Coronary sinus-anatomy and clinical implications. Shinzo 38:1181–1186 (in Japanese with English summary)

    Google Scholar 

  • Martínez-Villar M, Gran F, Ferrer Q, Giralt G, Sabaté-Rotés A, Albert DC (2016) Persistent left superior vena cava with absent right superior vena cava. Rev Esp Cardiol (Engl Ed) 69:220–221

    Article  Google Scholar 

  • Scherf D, Gurbuzer B (1958) Further studies on coronary sinus rhythm. Am J Cardiol 1:579–583

    CAS  Article  Google Scholar 

  • Scherf D, Harris R (1946) Coronary sinus rhythm. Am Heart J 32:443–456

    CAS  Article  Google Scholar 

  • Schreve-Steensma AM, van der Valk PHM, ten Kate JBL, Kofflard MJM (2008) Discovery of a persistent left superior vena cava during pacemaker implantation. Neth Heart J 16:272–274

    CAS  Article  Google Scholar 

  • Schummer W, Schummer C, Fröber R (2003) Persistent left superior vena cava and central venous catheter position: clinical impact illustrated by four cases. Surg Radiol Anat 25:315–321

    CAS  Article  Google Scholar 

  • Sheikh AS, Mazhar S (2014) Persistent left superior vena cava with absent right superior vena cava: review of the literature and clinical implications. Echocardiography 31:674–679

    Article  Google Scholar 

  • Shiraishi I (2018) Basic and comprehensive outlines of cardiovascular embryology and morphogenesis. Pediatr Cardiol Cardiac Surg 34:88–98 (in Japanese with English summary)

    Article  Google Scholar 

  • Webb WR, Gamsu G, Speckman JM, Kaiser JA, Federle MP, Lipton MJ (1982) Computed tomographic demonstration of mediastinal venous anomalies. AJR Am J Roentgenol 139:157–161

    CAS  Article  Google Scholar 

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We thank Dr. H. Nogami (Japan University of Health Sciences) for his advice and Mr. Y. Seya and Mr. K. Yabe (University of Tsukuba) for their technical support. We also thank the donor and her family for tissue donation and allowing us to publish this case report.

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Correspondence to Tomoyuki Masuda or Yosuke Takei.

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Ethical approval was obtained from the Medical Ethics Committee of the University of Tsukuba (#1137). Informed consent was obtained from all donors and their families.

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Shutoh, F., Masuda, T., Sasaki, T. et al. Anomalous atrium associated with persistent left superior vena cava. Anat Sci Int 96, 572–576 (2021).

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  • Atria
  • Cardiovascular anomaly
  • Coronary sinus
  • Gross anatomy
  • Persistent left superior vena cava