Skip to main content

Advertisement

SpringerLink
Log in

The persistent left superior vena cava: anatomical study, pathogenesis and clinical considerations

  • Anatomic Variations
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

The persistence of a left superior vena cava (LSVC) is an intrinsically cardiac anomaly, which can lead to serious complications during catheterization via the subclavian or internal jugular vein. We found this anomaly during dissection associated with an abnormal origin of the vertebral artery originating from the aortic arch between the left common carotid and subclavian arteries. The LSVC coursed towards the right atrium through a very dilated coronary sinus ostium. No abnormality of the azygos system was found. A thorough anatomic description was then made with external and internal morphology. The embryonic development and variations are described. Radiological and clinical implications are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Akalin H, Uysalel A, Osyurda U, Corapcioglu T, Eren NT, Emirogullari N, Erol C, Sonel A (1987) The triad of persistent left superior vena cava connected to the coronary sinus, right superior vena cava draining into the left atrium, and atrial septal defect: report of a successful operation for a rare anomaly. J Thorac Cardiovasc Surg 94:151–153

    PubMed  CAS  Google Scholar 

  2. Atwell WJ, Zolotwski P (1938) A case of left superior vena cava without a corresponding vessel on the right side. Anat Rec 70:525–532

    Article  Google Scholar 

  3. Barbaix E, Kerckaert I, D’herde K, Depreter M, Espeel M (2003) Simultaneous occurrence of a thyromediastinal muscle, a truncus bicarotidobrachialis, and a left superior vena cava. Clin Anat 16:176–181

    Article  PubMed  CAS  Google Scholar 

  4. Bergman RA, Thompson SA, Afifi AK, Saadeh FA (1988) Compendium of human anatomic variation. Urban & Schwarzenberg, Baltimore, pp 32–35, 88–89

  5. Chouke KS (1939) A case of bilateral superior vena cava in an adult. Anat Rec 74:151–157

    Article  Google Scholar 

  6. Congdon ED (1922) Transformation of the aortic-arch system during the development of the human embryo. Contrib Embryol Carnegie Inst 68:47–110

    Google Scholar 

  7. Daseler EH, Anson BJ (1959) Surgical anatomy of the subclavian artery and its branches. Surg Gynecol Obstet 108:149–174

    PubMed  CAS  Google Scholar 

  8. De Leval MR, Ritter DG, McGoon DC, Danielson GK (1975) Anomalous systemic venous connection: surgical considerations. Mayo Clin Proc 50:599–610

    PubMed  Google Scholar 

  9. Edwards J (1953) Pathological and developmental considerations in anomalous venous connections. Mayo Clin Proc 28:441–452

    CAS  Google Scholar 

  10. Fisher MR, Hricak H, Higgins CB (1985) Magnetic resonance imaging of developmental venous anomalies. AJR Am J Roentogenol 145:705–709

    CAS  Google Scholar 

  11. Foale R, Bourdillon PD, Sommerville J, Rickards A (1983) Anomalous systemic venous return: recognition by two-dimensional echocardiography. Eur Heart J 4:186–195

    PubMed  CAS  Google Scholar 

  12. Gensini GG, Caldini P, Casaccio F, Blount SC (1959) Persistent left superior vena cava. Am J Cardiol 4:677–685

    Article  PubMed  CAS  Google Scholar 

  13. Giebel J, Fanghänel J, Hauser S, Paul I (2000) A case of persistent left vena cava superior with atresia of the right atrial ostium of the coronary sinus. Ann Anat 182:191–194

    PubMed  CAS  Google Scholar 

  14. Keyes DC, Keyes HC (1925) A case of persistent of left superior vena cava with reversed azygos system. Anat Rec 31:23–26

    Article  Google Scholar 

  15. Kirklin JW, Barratt-Boyes BG (1993) Unroofed coronary syndrome. In: Kirklin JW (eds) Cardiac surgery. Churchill Livingstone, New York, pp 683–692

    Google Scholar 

  16. Halpert B (1927) Complete situs inversus of the vena cava superior. Anat Rec 35:38

    Google Scholar 

  17. Huang SK (1986) Persistent left superior vena cava in a man with ventricular fibrillation. Chest 89:155–157

    Article  PubMed  CAS  Google Scholar 

  18. Leibowitz AB, Halpern NA, Lee MH, Iberti TJ (1992) Left-sided superior vena cava: a not-so-unusual vascular anomaly discovered during central venous and pulmonary artery catheterization. Crit Care Med 20:1119–1122

    Article  PubMed  CAS  Google Scholar 

  19. Lenox CC, Zuberbuhler JR, Park SC, Neches WH, Mathews RA, Fricker FJ, Bahnson HT, Siewers RD (1980) Absent right superior vena cava with persistent left superior vena cava: implications and management. Am J Cardiol 45:117–122

    Article  PubMed  CAS  Google Scholar 

  20. Mantini E, Grondin CM, Lillehei CW, Edwards JE (1966) Congenital anomalies involving the coronary sinus. Circulation 33:317

    Google Scholar 

  21. Nandy K, Blair CB (1965) Double superior venae cavae with completely paired azygos veins. Anat Rec 151:1–10

    Article  PubMed  CAS  Google Scholar 

  22. Nishijima M, Harada J, Nogami K, Endo S, Takaku A (1989) Operative correction of kinking and coiling at the origin of vertebral artery and stellate ganglionectomy in patients with severe vertigo and dizziness. No Shinkei Geka 17:255–261

    PubMed  CAS  Google Scholar 

  23. Nizanowski C, Noczynski L, Suder E (1982) Variability of the origin of ramifications of the subclavian artery in humans (studies on the Polish population). Folia Morphol (Warsz) 41:281–294

    CAS  Google Scholar 

  24. Nsah EM, Moore GW, Hutchins GM (1991) Pathogenesis of persistent left superior vena cava with a coronary sinus connection. Pediatr Pathol 11:261–269

    Article  PubMed  CAS  Google Scholar 

  25. Papilian V, Rubin R (1923) Der Zusammenhang des Sinus venosus mit der Vena cava sinistra. Anat Anz 57:276–277

    Google Scholar 

  26. Roszel A (1966) Uber die Anomalie der Arteria subclavia dextra und die Persistenz der Vena Cava superior sinistra. Anat Anz 118:348–367

    PubMed  CAS  Google Scholar 

  27. Sabiston DCJ, Spencer FC (1995) Surgery of the chest, 6th edn. WB Saunders, Philadelphia, pp 1424

    Google Scholar 

  28. Sakamoto H, Akita K, Sato K, Sato T (1993) Left superior vena cava continuing to the accessory hemiazygos without anastomosis with the coronary sinus. Surg Radiol Anat 15:151–154

    Article  PubMed  CAS  Google Scholar 

  29. Santoscoy R, Walters HL III, Ross RD, Lyons JM, Hakimi M (1996) Coronary sinus ostial atresia with persistent left superior vena cava. Ann Thorac Surg 61:879–882

    Article  PubMed  CAS  Google Scholar 

  30. 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

    Article  PubMed  CAS  Google Scholar 

  31. Starck D (1975) Embryologie. Ein Lehrbuch auf allgemein biologischer Grundlage. 3. Aufl Geor Thieme, Stuttgart

  32. Taybi H, Curlander CJ, Lurie PR, Campbell JA (1965) Anomalous systemic venous connection to the left atrium or to a pulmonary vein. Am J Roentgenol Radium Ther Nucl Med 94:62–77

    PubMed  CAS  Google Scholar 

  33. Vakaet L, Poppelier G, Vermeire P (1958) Sur un des cas d’anomalie combinée de la veine cave supérieure et du système azygos. Acta Anat 32:235–239

    Article  PubMed  CAS  Google Scholar 

  34. Vorster W, du Plooy PT, Meiring JH (1998) Abnormal origin of internal thoracic and vertebral arteries. Clin Anat 11:33–37

    Article  PubMed  CAS  Google Scholar 

  35. Waikar HD, Lahie YK, De Zoysa L, Kamalanesan RP (2004) Systemic venous anomalies: absent right superior vena cava with persistent left superior vena cava. J Cardiothorac Vasc Anesth 18:332–335

    Article  PubMed  Google Scholar 

  36. Wallraff J (1939) Ein Fall von linker Vena cava superior ohne entsprechende Vene auf der rechten Seite. Anat Anz 87:305–311

    Google Scholar 

  37. Wasserman BA, Mikulis DJ, Manzione JV (1992) Origin of the right vertebral artery from the left side of the aortic arch proximal to the left subclavian artery. AJNR Am J Neuroradiol 12:355–358

    Google Scholar 

  38. Winters FS (1954) Persistent left superior vena cava: a survey of the world literature. Angiology 5:90–132

    Article  Google Scholar 

  39. Yener N, Sürücü HS, Dogan R, Aldur MM (2001) A case with dextrocardia, ventricular septal defect, persistent left superior vena cava and drainage of the great cardiac vein into the left internal thoracic vein. Surg Radiol Anat 23:205–206

    Article  PubMed  CAS  Google Scholar 

  40. Yilmaz AT, Arslan M, Demirkilic U, Kuralay E, Ozal E, Tatar H, Ozturk OY (1996) Partially unroofed coronary sinus syndrome with persistent left superior vena cava, absent right superior vena cava and right-sided pericardial defect. Eur J Cardio Thorac Surg 10:1027–1029

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Laboratoire d’Anatomie, Faculté de Médecine, Université François-Rabelais, 2 bis Boulevard Tonnelé, 37032, Tours Cedex, France

    J. Peltier, C. Destrieux, J. Desme & S. Velut

  2. Service de Radiologie, CHU Amiens Nord, Place Victor Pauchet, 80054, Amiens Cedex 1, France

    C. Renard & A. Remond

  3. Service de Neurochirurgie, Centre Hospitalier Universitaire d’Amiens, Place Victor Pauchet, 80054, Amiens Cedex 1, France

    J. Peltier

Authors
  1. J. Peltier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Destrieux
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Desme
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Renard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Remond
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Velut
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Peltier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Peltier, J., Destrieux, C., Desme, J. et al. The persistent left superior vena cava: anatomical study, pathogenesis and clinical considerations. Surg Radiol Anat 28, 206–210 (2006). https://doi.org/10.1007/s00276-005-0067-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-005-0067-7

Keywords

Search

Navigation