title: Incidence of persistent left superior vena cava in esophageal atresia.
abstract: OBJECTIVE
  Esophageal atresia is known to be associated with a variety of additional congenital anomalies in multiple organ systems. Emphasis on cardiovascular anomalies has been focused on aortic arch and intrinsic cardiac malformations. Persistent left superior vena cava (PLSVC) is the most common venous thoracic anomaly in the general population and creates a problem when central venous access is required. This review was undertaken to define the incidence of PLSVC in infants with esophageal atresia and to determine if any subgroup of associated anomalies poses additional risk.
  
  
  METHODS
  A retrospective, institutional review board-approved review of all children treated for esophageal atresia from 1993 to 2002 at Riley Hospital for Children was undertaken. Of 118 children, 89 had sufficient data for inclusion. Charts were reviewed for gestational age, weight, type of atresia, echocardiogram, and associated anomalies. Statistical analysis was performed using the Fisher's Exact test.
  
  
  RESULTS
  Of 89 children, 8 (9.9%; confidence interval, 4%-17%) had PLSVC compared with the reported incidence of 0.3% in the general population. Presence of additional organ system anomalies did not significantly increase relative risk for PLSVC.
  
  
  CONCLUSIONS
  The incidence of PLSVC is significantly increased in children with esophageal atresia when compared with the general population. This increased incidence of PLSVC is not influenced by the presence of cardiac or other associated anomalies. This finding should be kept in mind when central venous access is required in this patient population.
authors.affiliation: JW Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Mowery
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Billmire
authors.forename: Marcus
authors.initials: M
authors.lastname: Schamberger
authors.forename: Paul
authors.initials: P
authors.lastname: Szotek
authors.forename: Karen W
authors.initials: KW
authors.lastname: West
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Rescorla
authors.forename: L R
authors.initials: LR
authors.lastname: Scherer
authors.forename: Scott
authors.initials: S
authors.lastname: Engum
authors.forename: Thomas
authors.initials: T
authors.lastname: Rouse
authors.forename: Jay L
authors.initials: JL
authors.lastname: Grosfeld
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology; D004933:Esophageal Atresia / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014683:Vena Cava, Superior / Q000002:abnormalities*