Persistent left superior vena cava is a rare congenital anomaly that can complicate right heart access via the left subclavian approach and is often suspected when a dilated coronary sinus is seen on echocardiography.
Case Report (n=1)
Incidental finding of a dilated coronary sinus on echocardiography should prompt evaluation for persistent left superior vena cava using saline contrast echocardiography to prevent complications during right heart access procedures.
Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress. It is most commonly observed in isolation but can be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cor triatriatum. The presence of PLSVC can render access to the right side of heart challenging via the left subclavian approach, which is a common site of access utilized when placing pacemakers and Swan-Ganz catheters. Incidental notation of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by saline contrast echocardiography.
Goyal et al. (Fri,) conducted a case report in Persistent left superior vena cava (n=1). Persistent left superior vena cava was evaluated. Persistent left superior vena cava is a rare congenital anomaly that can complicate right heart access via the left subclavian approach and is often suspected when a dilated coronary sinus is seen on echocardiography.