Cornel Savu1,2, Cornel Petreanu1,2, Alexandru Melinte1, Radu Posea1, Irina Balescu3, Laura Iliescu2,4, Camelia Diaconu2,5, Nicolae Galie1,2, Nicolae Bacalbasa2,6,7. 1. Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumophthisiology, Bucharest, Romania. 2. Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. 3. Department of Visceral Surgery, "Ponderas Academic Hospital", Bucharest, Romania irina.balescu@ponderas-ah.ro. 4. Department of Internal Medicine, "Fundeni" Clinical Institute, Bucharest, Romania. 5. Department of Internal Medicine, "Floreasca" Emergency Clinical Hospital, Bucharest, Romania. 6. Department of Visceral Surgery, Center of Excellence in Translational Medicine, "Fundeni" Clinical Institute, Bucharest, Romania. 7. Department of Obstetrics and Gynecology, "I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
Abstract
BACKGROUND/AIM: The presence of the superior left vena cava represents a rare anomaly of the thoracic venous system. CASE REPORT: An asymptomatic case of this type of anomaly, discovered as an accident during investigations for a different pathology (superior left pulmonary lobe tumor), is presented. A 56-year-old, heavy smoker was admitted in our clinic with a tumoral mass in the left superior pulmonary lobe discovered during a routine chest x-ray. Physical and clinical examination was normal. However, transthoracic echography noted a coronary sinus enlargement, which led to the suspicion of a thoracic venous anomaly. Contrast chest computed tomography pointed out a venous anomaly at the level of the left hemithorax originating from the cervical region, crossing the aortic arch and draining in the coronary sinus. During the examination, contrast substance was not detected in the right superior vena cava, either early or late during the computed tomography. During surgery the presence of a persistent left superior vena cava was observed, coming from the cervical region, crossing lateral to the aortic arch and draining in the coronary sinus. CONCLUSION: The presence of an enlarged coronary sinus should warn the surgeon about the possibility of a thoracic venous anomaly. Identifying a persistent left superior vena cava is important due to its clinical implications, especially during certain procedures such as mounting central venous lines, cardiac cannulation or implantation of cardiac stimulators. Copyright
BACKGROUND/AIM: The presence of the superior left vena cava represents a rare anomaly of the thoracic venous system. CASE REPORT: An asymptomatic case of this type of anomaly, discovered as an accident during investigations for a different pathology (superior left pulmonary lobe tumor), is presented. A 56-year-old, heavy smoker was admitted in our clinic with a tumoral mass in the left superior pulmonary lobe discovered during a routine chest x-ray. Physical and clinical examination was normal. However, transthoracic echography noted a coronary sinus enlargement, which led to the suspicion of a thoracic venous anomaly. Contrast chest computed tomography pointed out a venous anomaly at the level of the left hemithorax originating from the cervical region, crossing the aortic arch and draining in the coronary sinus. During the examination, contrast substance was not detected in the right superior vena cava, either early or late during the computed tomography. During surgery the presence of a persistent left superior vena cava was observed, coming from the cervical region, crossing lateral to the aortic arch and draining in the coronary sinus. CONCLUSION: The presence of an enlarged coronary sinus should warn the surgeon about the possibility of a thoracic venous anomaly. Identifying a persistent left superior vena cava is important due to its clinical implications, especially during certain procedures such as mounting central venous lines, cardiac cannulation or implantation of cardiac stimulators. Copyright
Authors: Khalil Kanjwal; Michael Soos; Daniel Gonzalez-Morales; Ibrahim Shah; Mohan Madala; Majid Mughal; Muhammad Awais Kang Journal: Case Rep Cardiol Date: 2019-07-29