Journal of Capital Medical University ›› 2013, Vol. 34 ›› Issue (2): 308-314.doi: 10.3969/j.issn.1006-7795.2013.02.028

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Clinical study of the isolated persistent left superior vena cava

LI Xiaoyu, YUAN Yuan, ZHANG Ping   

  1. Department of Geriatrics, Beijing Jishuitan Hospital, The 4th Medical College of Peking University, Beijing 100035, China
  • Received:2012-11-13 Online:2013-04-21 Published:2013-04-17

Abstract:

Objective A systematic analysis on the clinical features, natural history, diagnosis and treatment experience of isolated persistent left superior vena cava(PLSVC) was done. Methods Collected the symptoms succession and nearly 21 years of examination and detection data of one 78-year old case with isolated PLSVC, then did a comparative analysis. Results The case was without positive symptoms until 57-year-old, which was sinus bradycardia. Dual-chamber pacemaker was implanted due to the sick sinus syndrome 11 years ago, before implantation, examinations showed leukocytes, and reduction of platelets, PLSVC was found during the surgery. Seven years ago, the performances of abdominal venous congestion were visualized, and 5 years ago, he was presented to clinics due to severe tricuspid regurgitation and right ventricular dysfunction. Three months ago, his chest enhanced CT+ 3D cardiovascular reconstruction cleared the abnormalities of isolated PLSVC. Conclusion The delayed occurrence of isolated PLSVC symptoms motivates misdiagnosis of this malformation, whose first manifestation is often kinds of arrhythmias. Tricuspid systolic murmur could be found quite early. Echocardiography is the preferred screening method, cardiac catheterization or enhanced CT+3D cardiovascular reconstruction could manifested it. The treatments of cardiac arrhythmias include pacemaker implantation and coronary sinus target ablation. Some patients required early surgical treatment, at advanced stage, heart transplantation may be considered.

Key words: isolated persistent left superior vena cava(PLSVC), dilated coronary sinus(DCS), absent right superior vena cava(ARSVC), diagnosis and treatment

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