title: Persistent left superior vena cava draining to left atrium with normal coronary sinus.
abstract: In embryology, a persistent connection of the left superior vena cava to the left atrium rarely coexists with a coronary sinus. We herein report an unusual case of persistent left superior vena cava terminating in a left atrium with normal coronary sinus, which was revealed at the time of permanent pacemaker implantation after a second operation for recurrent left atrioventricular valve regurgitation. Because this anomaly had gone undiagnosed at the first operation, we were unable to diagnose it prior to the second operation, because the preoperative coronary angiogram clearly demonstrated a coronary sinus that was not dilated. We would have repaired the anomaly using a patch or other procedure had it been diagnosed before the second operation in order to prevent cyanosis or brain complications secondary to right-to-left shunting. One should always be on guard for this rare condition.
authors.affiliation: Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kato
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Minamimura
authors.forename: Takumi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Ohue
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000473:pathology* / Q000601:surgery; D005260:Female; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012086:Reoperation; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014683:Vena Cava, Superior / Q000002:abnormalities*
references.citation: Mayo Clin Proc. 1965 Jul;40:528-32
references.pmid: 14346187
references.citation: Br Heart J. 1991 Mar;65(3):158-60
references.pmid: 2015125
references.citation: Ann Thorac Surg. 1979 May;27(5):418-25
references.pmid: 454016