Highlights the importance of echocardiographic examination of coronary sinus caliber to suspect PLSVC when assessing hemodialysis access in ESRD patients.
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May warrant coronary sinus evaluation on echo in left-sided AV fistula patients; leaves open need for prospective validation in ESRD.
We present an interesting case illustrating the possible hemodynamic consequences when a left-sided arteriovenous hemodialysis fistula is combined with the congenital anomaly of a persistent left superior vena cava (PLSVC). Our case illustrates the importance of an echocardiographic examination with attention to the coronary sinus (CS) caliber-raising suspicion of a PLSVC-in the assessment for the hemodialysis access in end-stage renal disease patients. The causes and symptoms of CS dilatation, as well as the literature on PLSVC, are also discussed in detail.
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Wolf et al. (2012) studied this question.
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