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Left Superior Vena Cava
Gerald F. Abbott, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Persistent left superior vena cava (PLSVC)
            • Definitions

              • Left-sided superior vena cava arising from confluence of ipsilateral subclavian & internal jugular veins
              • Typically drains to coronary sinus & occasionally to left atrium ± unroofed coronary sinus (i.e., coronary sinus atrial septal defect)

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        • Echocardiographic Findings

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Ozaki N et al: Surgical repair of coronary sinus atrial septal defect and supraventricular tachycardia. Interact Cardiovasc Thorac Surg. 8(2):290-1, 2009
                                              2. Thangaroopan M et al: Images in cardiovascular medicine. Rare case of an unroofed coronary sinus: diagnosis by multidetector computed tomography. Circulation. 119(16):e518-20, 2009
                                              3. Kong PK et al: Unroofed coronary sinus and persistent left superior vena cava. Eur J Echocardiogr. 8(5):398-401, 2007
                                              4. Piacentini G et al: Persistent left superior vena cava into unroofed coronary sinus. Lancet. 368(9551):1963-4, 2006
                                              5. Sueyoshi E et al: Persistent left superior vena cava into left atrium. Lancet. 368(9543):1270, 2006
                                              6. Gonzalez-Juanatey C et al: Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review. Clin Cardiol. 27(9):515-8, 2004
                                              7. Eckart RE et al: Utility of magnetic resonance imaging in cardiac venous anatomic variants. Cardiovasc Intervent Radiol. 26(3):309-11, 2003
                                              8. Haramati LB et al: Computed tomography of partial anomalous pulmonary venous connection in adults. J Comput Assist Tomogr. 27(5):743-9, 2003
                                              9. Ootaki Y et al: Unroofed coronary sinus syndrome: diagnosis, classification, and surgical treatment. J Thorac Cardiovasc Surg. 126(5):1655-6, 2003
                                              10. Tak T et al: Persistent left superior vena cava: incidence, significance and clinical correlates. Int J Cardiol. 82(1):91-3, 2002
                                              11. Hahm JK et al: Magnetic resonance imaging of unroofed coronary sinus: three cases. Pediatr Cardiol. 21(4):382-7, 2000
                                              12. Sarodia BD et al: Persistent left superior vena cava: case report and literature review. Respir Care. 45(4):411-6, 2000
                                              13. Palacios-Macedo AX et al: Correction of anomalous systemic venous drainage in heterotaxy syndrome. Ann Thorac Surg. 64(1):235-7; discussion 237-8, 1997
                                              14. Raptopoulos V: Computed tomography of the superior vena cava. Crit Rev Diagn Imaging. 25(4):373-429, 1986
                                              15. Brown KT et al: Pseudoprominent aorta: radiographic findings and CT correlation. Radiology. 155(2):299-301, 1985
                                              16. Fisher MR et al: Magnetic resonance imaging of developmental venous anomalies. AJR Am J Roentgenol. 145(4):705-9, 1985
                                              17. Huggins TJ et al: CT appearance of persistent left superior vena cava. J Comput Assist Tomogr. 6(2):294-7, 1982
                                              18. Baron RL et al: CT of anomalies of the mediastinal vessels. AJR Am J Roentgenol. 137(3):571-6, 1981
                                              19. Lam W et al: Left-to-right shunt via left superior vena cava communication with left atrium. Chest. 79(6):700-2, 1981
                                              20. Cha EM et al: Persistent left superior vena cava. Radiologic and clinical significance. Radiology. 103(2):375-81, 1972
                                              21. Raghib G et al: Termination of left superior vena cava in left atrium, atrial septal defect, and absence of coronary sinus; a developmental complex. Circulation. 31:906-18, 1965
                                              22. Campbell M et al: The left-sided superior vena cava. Br Heart J. 16(4):423-39, 1954
                                              23. Winter FS: Persistent left superior vena cava; survey of world literature and report of thirty additional cases. Angiology. 5(2):90-132, 1954
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Persistent left superior vena cava (PLSVC)
                                                        • Definitions

                                                          • Left-sided superior vena cava arising from confluence of ipsilateral subclavian & internal jugular veins
                                                          • Typically drains to coronary sinus & occasionally to left atrium ± unroofed coronary sinus (i.e., coronary sinus atrial septal defect)

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Angiographic Findings

                                                                  • Imaging Recommendations

                                                                    • Echocardiographic Findings

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Ozaki N et al: Surgical repair of coronary sinus atrial septal defect and supraventricular tachycardia. Interact Cardiovasc Thorac Surg. 8(2):290-1, 2009
                                                                                          2. Thangaroopan M et al: Images in cardiovascular medicine. Rare case of an unroofed coronary sinus: diagnosis by multidetector computed tomography. Circulation. 119(16):e518-20, 2009
                                                                                          3. Kong PK et al: Unroofed coronary sinus and persistent left superior vena cava. Eur J Echocardiogr. 8(5):398-401, 2007
                                                                                          4. Piacentini G et al: Persistent left superior vena cava into unroofed coronary sinus. Lancet. 368(9551):1963-4, 2006
                                                                                          5. Sueyoshi E et al: Persistent left superior vena cava into left atrium. Lancet. 368(9543):1270, 2006
                                                                                          6. Gonzalez-Juanatey C et al: Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review. Clin Cardiol. 27(9):515-8, 2004
                                                                                          7. Eckart RE et al: Utility of magnetic resonance imaging in cardiac venous anatomic variants. Cardiovasc Intervent Radiol. 26(3):309-11, 2003
                                                                                          8. Haramati LB et al: Computed tomography of partial anomalous pulmonary venous connection in adults. J Comput Assist Tomogr. 27(5):743-9, 2003
                                                                                          9. Ootaki Y et al: Unroofed coronary sinus syndrome: diagnosis, classification, and surgical treatment. J Thorac Cardiovasc Surg. 126(5):1655-6, 2003
                                                                                          10. Tak T et al: Persistent left superior vena cava: incidence, significance and clinical correlates. Int J Cardiol. 82(1):91-3, 2002
                                                                                          11. Hahm JK et al: Magnetic resonance imaging of unroofed coronary sinus: three cases. Pediatr Cardiol. 21(4):382-7, 2000
                                                                                          12. Sarodia BD et al: Persistent left superior vena cava: case report and literature review. Respir Care. 45(4):411-6, 2000
                                                                                          13. Palacios-Macedo AX et al: Correction of anomalous systemic venous drainage in heterotaxy syndrome. Ann Thorac Surg. 64(1):235-7; discussion 237-8, 1997
                                                                                          14. Raptopoulos V: Computed tomography of the superior vena cava. Crit Rev Diagn Imaging. 25(4):373-429, 1986
                                                                                          15. Brown KT et al: Pseudoprominent aorta: radiographic findings and CT correlation. Radiology. 155(2):299-301, 1985
                                                                                          16. Fisher MR et al: Magnetic resonance imaging of developmental venous anomalies. AJR Am J Roentgenol. 145(4):705-9, 1985
                                                                                          17. Huggins TJ et al: CT appearance of persistent left superior vena cava. J Comput Assist Tomogr. 6(2):294-7, 1982
                                                                                          18. Baron RL et al: CT of anomalies of the mediastinal vessels. AJR Am J Roentgenol. 137(3):571-6, 1981
                                                                                          19. Lam W et al: Left-to-right shunt via left superior vena cava communication with left atrium. Chest. 79(6):700-2, 1981
                                                                                          20. Cha EM et al: Persistent left superior vena cava. Radiologic and clinical significance. Radiology. 103(2):375-81, 1972
                                                                                          21. Raghib G et al: Termination of left superior vena cava in left atrium, atrial septal defect, and absence of coronary sinus; a developmental complex. Circulation. 31:906-18, 1965
                                                                                          22. Campbell M et al: The left-sided superior vena cava. Br Heart J. 16(4):423-39, 1954
                                                                                          23. Winter FS: Persistent left superior vena cava; survey of world literature and report of thirty additional cases. Angiology. 5(2):90-132, 1954