Persistent Left Superior Vena Cava Demonstrated With Multislice Spiral Computed Tomography
A 64-year-old man with atypical angina presented for participation in a clinical trial of minimally invasive coronary angiography with use of contrast-enhanced, retrospectively gated multislice spiral computed tomography (Figure). Two of the 12 coronary segments defined by the American Heart Association could not be assessed because of dense calcification; the remaining segments were free of significant obstructions. A persistent left superior vena cava (PLSVC) connected to the coronary sinus was noted incidentally. There were no associated cardiac malformations. A PLSVC connected to the coronary sinus is the most common anomaly of systemic venous return. This anomaly usually requires no treatment unless it is associated with other cardiac malformations. However, it can create problems with procedures that require access to the right ventricle or pulmonary artery or with new therapeutic techniques that make use of the cardiac veins overlying the left ventricle, such as left ventricular pacing or percutaneous in situ coronary venous arterialization.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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