Multimodality imaging of persistent left superior vena cava and an absent right superior vena cava in a patient with dextrocardia/Sag superiyor vena kavanin olmadigi dekstrokardili bir hastada persistan sol superiyor vena kavanin coklu goruntuleme ile gosterilmesi.
Persistent left superior vena cava (PLSVC) is relatively rare but is one of the most common congenital anomalies of the systemic venous return, occurring in 0.3% to 0.5% in the general population. About 12% of those are accompanied by congenital heart abnormalities including atrial and ventricular septal defect, aortic coarctation, transposition of the great vessels and Tetralogy of Fallot. Although PLSVC is often associated with a normal right side venous drainage, PLSVC with an absent right superior vena cava (RSVC), known as "isolated PLSVC", is an extremely rare condition.
A 24-year-old man was admitted to our outpatient clinic for routine evaluation. Heart sounds were heard on the right. Two-dimensional transthoracic echocardiography revealed dextrocardia and dilated coronary sinus (CS) (Fig. 1A, Video 1A). To clarify this pathology, we performed two and three-dimensional transesophageal echocardiography (2D and 3D TEE), and computed tomography (CT). Four-chamber view of 2D TEE showed a small right atrium due to a different shape of interatrial septum (Fig. 1B, Video 1B). Two-chamber view of 2D TEE demonstrated dilated CS (Fig. 1C, Video 1C). 3D TEE full-volume image after cropping showed PLSVC and dilated CS (Fig. 1D, Video 1D). Colored subvolume (Fig. 2A, B), colored three-dimensional volume rendered (Fig. 2C) and oblique sagittal MPR CT images (Fig. 2D) also revealed PLSVC and dilated CS. Here we report a case of PLSVC with an absent RSVC resulting in a giant CS in a patient with dextrocardia. Multimodality imaging can help in better diagnosing this condition.
Sait Demirkol, Sevket Balta, Sabahattin Sari *, Ugur Bozlar *
From Departments of Cardiology and * Radiology, Gulhane Military Medical Academy, Ankara-Turkey
Video 1A. Two dimensional transthoracic echocardiography revealed dextrocardia and dilated coronary sinus
Video 1B. Two dimensional transesophageal echocardiography four chamber view showed small right atrium
Video 1C. Two dimensional transesophageal echocardiography two chamber view demonstrated dilated coronary sinus
Video 1D. Three dimensional transesophageal echocardiography full-volume image after cropping showed persistent left superior vena cava and dilated coronary sinus
Address for Correspondence/Yazisma Adresi: Dr. Sait Demirkol, Gulhane Askeri Tip Akademisi, Kardiyoloji Klinigi, Ankara-Turkiye
Phone: +90 312 304 42 81
Available Online Date/Cevrimici Yayin Tarihi: 10.09.2013
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|Title Annotation:||E-page Original Images/E-sayfa Ozgun Goruntuler|
|Author:||Demirkol, Sait; Balta, Sevket; Sari, Sabahattin; Bozlar, Ugur|
|Publication:||The Anatolian Journal of Cardiology (Anadolu Kardiyoloji Dergisi)|
|Date:||Sep 1, 2013|
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