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Bicameral Pacemaker Implant in an Extremely Rare Case of Left Superior Vena Cava Anatomic Variant

Received: 22 October 2018     Accepted: 15 November 2018     Published: 19 December 2018
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Abstract

The most common congenital venous anomaly of the thoracic systemic venous return is the persistence of the left superior vena cava (PLSVC), occurring in 0.3% to 0.5% of individuals in the general population, and in 12% of individuals with other congenital heart abnormalities. 50% of the patients with isolated PLSVC have other cardiac malformations (atrial septal defect, endocardial cushion or tetralogy of Fallot). The basis for persistence of the left superior vena cava (LSVC), usually associated with other cardiac malformations, is poorly understood. The presence of a PLSVC has a significant influence of the anatomy of the heart and venous system. There is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians actively involved in central venous access device placement. The current review is a case report of persistent left superior vena cava associated with severe disorders of intra-cardiac conduction leading to specific symptoms. This venous malformation was identifies incidentally in a 80 years old patient during the procedure of pacemaker implantation. The venography showed isolated PLSVC with a bridging vein that drained the right jugular and right subclavian vein and joined the left brachiocephalic vein to form the PLSVC, which descendent on the left side of the mediastinum and drained into the right atrium via a dilated coronary sinus.

Published in Cardiology and Cardiovascular Research (Volume 2, Issue 4)
DOI 10.11648/j.ccr.20180204.14
Page(s) 91-97
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Central Venous Access, Venography, Persistent Left Superior Vena Cava, Pacemaker, Vascular Malformation, Total Atrioventricular Block

References
[1] Antonio Navarrete, Louis Janeira, Indiana University Health; Ablation of a Left-Sided WPW in a Patient with Total Upper Venous Return through a Persistent Left Superior Vena; Issue number: volume 13, issue 2, February 2013, www.eplabdigest.com.
[2] Sandeep K Goyal, Sujeeth R Punnam, Gita Verma and Frederick I Ruberg; Persistent left superior vena cava: a case report and review of literature – Cardiovascular Ultrasound 2008.
[3] Kamil W Tyrak, Mateusz K Hołda, Mateusz Koziej, Katarzyna Piątek, and Wiesława Klimek-Piotrowska, Persistent left superior vena cava, Cardiovasc Journal of Africa. 2017 May-Jun; 28(3): e1–e4. doi: 10.5830/CVJA-2016-084.
[4] Povoski SP. Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011; 9: 173–173.[PubMed]
[5] Lenox CC, Zuberbuhler JR, Park SC, Neches WH, Mathews RA, Fricker FJ. et al. Absent right superior vena cava with persistent left superior vena cava: implications and management. Am J Cardiol. 1980; 45(1): 117–122. [PubMed]
[6] Sarodia BD, Stoller JK. Persistent left superior vena cava: case report and literature review. Respir Care. 2000; 45(4):411–416. [PubMed]
[7] Ozgul Ucar, Hulya Cicekcioglu, Ibrahim Kocaoglu, Sinan Aydogdu, Lale Pasaoglu, Murat Vural, Persistent left superior vena cava with absent right superior vena cava: a case report and review of the literature, Cardiovasc J Afr. 2010 Jun; 21(3): 164–166.
[8] luckianow G, Cole D, Kaplan L. Anatomical variant found during catheter insertion. J Am Acad Phys Assist. 2009; 22(9):60–63. [PubMed]
[9] Rubenfire M, Evangelista J, Wajszczuk WJ, Kantrowitz A. Implication of a persistent left superior vena cava in transvenous pacemaker therapy and cardiac hemodynamic monitoring. Chest. 1974; 65:145–147. [PubMed]
[10] Nsah EN1, Moore GW, Hutchins GM. Pathogenesis of persistent left superior vena cava with a coronary sinus connection. Pediatr Pathol. 1991Mar-Apr; 11(2):261-9.
[11] Uçar O1, Pasaoglu L, Ciçekçioglu H, Vural M, Kocaoglu I, Aydogdu S. Persistent left superior vena cava with absent right superior vena cava: a case report and review of the literature. Cardiovasc J Afr. 2010 May-Jun; 21(3):164-6.
[12] Liu X1, He Y2, Tian Z3, Rychik J3. Persistent Left Superior Vena Cava Connected to the Coronary Sinus in the Fetus: Effects on Cardiac Structure and Flow Dynamics. Pediatr Cardiol. 2016 Aug; 37(6):1085-90. Epub 2016 Apr 15.
[13] Elison B1, Evans D2, Zanders T1, Jeanmonod R1. Persistent left superior vena cava draining into the pulmonary venous system discovered after central venous catheter placement. Am J Emerg Med. 2014 Aug; 32(8): 943.e1-3. Epub 2013 Dec 27.
[14] Petrac D1, Radeljic V1, Pavlovic N1, Manola S1, Delic-Brkljacic D1. Persistent Left Superior Vena Cava in Patients Undergoing Cardiac Device Implantation: Clinical and Long-Term Data. Cardiol Res. 2013 Apr; 4(2):64-67. Epub 2013 May 9.
[15] Anna Żabówka, Jakub Kotarba, Zbigniew Siudak, and Dariusz Dudek. Single and dual chamber pacemaker implantation in patients with left superior vena cava persistence – own experiences. Postepy Kardiol Interwencyjnej. 2017; 13(2): 170–172.
[16] Meijboom WB1, Vanderheyden M. Biventricular pacing and persistent left superior vena cava. Case report and review of the literature. Acta Cardiol. 2002 Aug; 57(4):287-90.
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Cite This Article
  • APA Style

    Lorena Harbuz, Camelia Georgescu, Octavian Zara, Sergiu Sipos, Radu Ciudin. (2018). Bicameral Pacemaker Implant in an Extremely Rare Case of Left Superior Vena Cava Anatomic Variant. Cardiology and Cardiovascular Research, 2(4), 91-97. https://doi.org/10.11648/j.ccr.20180204.14

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    ACS Style

    Lorena Harbuz; Camelia Georgescu; Octavian Zara; Sergiu Sipos; Radu Ciudin. Bicameral Pacemaker Implant in an Extremely Rare Case of Left Superior Vena Cava Anatomic Variant. Cardiol. Cardiovasc. Res. 2018, 2(4), 91-97. doi: 10.11648/j.ccr.20180204.14

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    AMA Style

    Lorena Harbuz, Camelia Georgescu, Octavian Zara, Sergiu Sipos, Radu Ciudin. Bicameral Pacemaker Implant in an Extremely Rare Case of Left Superior Vena Cava Anatomic Variant. Cardiol Cardiovasc Res. 2018;2(4):91-97. doi: 10.11648/j.ccr.20180204.14

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  • @article{10.11648/j.ccr.20180204.14,
      author = {Lorena Harbuz and Camelia Georgescu and Octavian Zara and Sergiu Sipos and Radu Ciudin},
      title = {Bicameral Pacemaker Implant in an Extremely Rare Case of Left Superior Vena Cava Anatomic Variant},
      journal = {Cardiology and Cardiovascular Research},
      volume = {2},
      number = {4},
      pages = {91-97},
      doi = {10.11648/j.ccr.20180204.14},
      url = {https://doi.org/10.11648/j.ccr.20180204.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20180204.14},
      abstract = {The most common congenital venous anomaly of the thoracic systemic venous return is the persistence of the left superior vena cava (PLSVC), occurring in 0.3% to 0.5% of individuals in the general population, and in 12% of individuals with other congenital heart abnormalities. 50% of the patients with isolated PLSVC have other cardiac malformations (atrial septal defect, endocardial cushion or tetralogy of Fallot). The basis for persistence of the left superior vena cava (LSVC), usually associated with other cardiac malformations, is poorly understood. The presence of a PLSVC has a significant influence of the anatomy of the heart and venous system. There is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians actively involved in central venous access device placement. The current review is a case report of persistent left superior vena cava associated with severe disorders of intra-cardiac conduction leading to specific symptoms. This venous malformation was identifies incidentally in a 80 years old patient during the procedure of pacemaker implantation. The venography showed isolated PLSVC with a bridging vein that drained the right jugular and right subclavian vein and joined the left brachiocephalic vein to form the PLSVC, which descendent on the left side of the mediastinum and drained into the right atrium via a dilated coronary sinus.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Bicameral Pacemaker Implant in an Extremely Rare Case of Left Superior Vena Cava Anatomic Variant
    AU  - Lorena Harbuz
    AU  - Camelia Georgescu
    AU  - Octavian Zara
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    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
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    EP  - 97
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20180204.14
    AB  - The most common congenital venous anomaly of the thoracic systemic venous return is the persistence of the left superior vena cava (PLSVC), occurring in 0.3% to 0.5% of individuals in the general population, and in 12% of individuals with other congenital heart abnormalities. 50% of the patients with isolated PLSVC have other cardiac malformations (atrial septal defect, endocardial cushion or tetralogy of Fallot). The basis for persistence of the left superior vena cava (LSVC), usually associated with other cardiac malformations, is poorly understood. The presence of a PLSVC has a significant influence of the anatomy of the heart and venous system. There is very little in the literature that specifically addresses the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians actively involved in central venous access device placement. The current review is a case report of persistent left superior vena cava associated with severe disorders of intra-cardiac conduction leading to specific symptoms. This venous malformation was identifies incidentally in a 80 years old patient during the procedure of pacemaker implantation. The venography showed isolated PLSVC with a bridging vein that drained the right jugular and right subclavian vein and joined the left brachiocephalic vein to form the PLSVC, which descendent on the left side of the mediastinum and drained into the right atrium via a dilated coronary sinus.
    VL  - 2
    IS  - 4
    ER  - 

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Author Information
  • Department of Cardiology, "St. Ioan" Clinical Emergency Hospital, Bucharest, Romania

  • Department of Cardiology, "St. Ioan" Clinical Emergency Hospital, Bucharest, Romania

  • Department of Cardiology, "St. Ioan" Clinical Emergency Hospital, Bucharest, Romania

  • Department of Cardiology, Emergency Institute for Cardiovascular Diseases "Prof. CC Lliescu", Bucharest, Romania

  • Department of Medicine, Section of Cardiology, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania

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