Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Aug 11:16:528-31.
doi: 10.12659/AJCR.894394.

A Rare Association of Sinus Venosus-Type Atrial Septal Defect and Persistent Left Superior Vena Cava Detected by Transthoracic Echocardiography and Cardiac Magnetic Resonance Imaging

Tarek M Mousa  1 , Oluwaseun A Akinseye  2 , Todd C Kerwin  3 , Olakunle O Akinboboye  1
Affiliations
Case Reports

A Rare Association of Sinus Venosus-Type Atrial Septal Defect and Persistent Left Superior Vena Cava Detected by Transthoracic Echocardiography and Cardiac Magnetic Resonance Imaging

Tarek M Mousa et al. Am J Case Rep. .

Abstract

Background: Association of persistent left superior vena cava (PLSVC) and sinus venosus-type atrial septal defect (SVASD) is rare. We describe a patient with dilated coronary sinus (CS) found to have PLSVC and SVASD.

Case report: The patient is a 60-year-old man with history of stroke who underwent a transthoracic echocardiogram (TTE) for evaluation of shortness of breath. TTE demonstrated a markedly dilated CS. Agitated saline was injected into the left antecubital vein to further assess CS. The parasternal long axis view demonstrated immediate filling of the CS and confirmed the presence of a PLSVC. Apical 4-chamber view with injection of agitated saline into the right antecubital vein demonstrated immediate contrast opacification of both atria, consistent with a right to left cardiac shunt. Cardiac magnetic resonance (CMR) was performed, which confirmed the TTE findings of PLSVC and defined the cardiac shunt as SVASD.

Conclusions: PLSVC should be suspected in a patient with an abnormally dilated CS. In this case we identified a rare association of PLSVC with a SVASD. TTE with agitated saline contrast injection and CMR are useful diagnostic tools for PLSVC and associated cardiac congenital anomalies, respectively.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Parasternal long axis view of the CS without saline contrast injection into the left antecubital vein. CS – coronary sinus.
Figure 2
Figure 2
Parasternal long axis view with saline contrast injected into the left antecubital vein demonstrating immediate filling of the coronary sinus consistent with the presence of a persistent left superior vena cava. * Filling of coronary sinus.
Figure 3
Figure 3
Apical 4-chamber view without saline contrast injection into the right antecubital vein. RA – right atrium, LA – left atrium.
Figure 4
Figure 4
Apical 4-chamber view with saline contrast injected into the right antecubital vein demonstrating immediate contrast opacification of both atria, consistent with a right-to-left cardiac shunt. RA – right atrium, LA – left atrium.
Figure 5
Figure 5
Cardiac magnetic resonance confirming the findings of persistent left superior vena cava (arrow).
Figure 6
Figure 6
Cardiac magnetic resonance confirming the cardiac shunt as sinus venosus-type atrial septal defect (arrow head).
See this image and copyright information in PMC

References

    1. Bhatti S, Hakeem A, Ahmad U, et al. Persistent left superior vena cava (PLSVC) with anomalous left hepatic vein drainage into the right atrium: Role of imaging and clinical relevance. Vasc Med. 2007;12(4):319–24. - PubMed
    1. Vercruysse J, François K, De Wolf A, et al. Persistent left superior vena cava (PLSVC) connected to the left atrium. Acta Anaesthesiol Belg. 2010;61:39–41. - PubMed
    1. Biffi M, Boriani G, Frabetti L, et al. Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator Implantation. A 10-year experience. Chest. 2001;120(1):139–44. - PubMed
    1. Goyal SK, Punnam SR, Verma G, Ruberg FL. Persistent left superior vena cava: A case report and review of literature. Cardiovasc Ultr. 2008;6(1):1–4. - PMC - PubMed
    1. Sadler TW. Langman’s Medical Embryology. 7th. Baltimore: Williams and Wilkins; 1995. pp. 221–23.

Publication types

Supplementary concepts