Persistent left superior vena cava: what the interventional nephrologist needs to know.
Variations in the course of the blood vessels are often incidental findings during clinical examination. Persistent left superior vena cava (PLSVC) is an uncommon anomaly, estimated to be present in about 0.3-0.5% of healthy individuals and in about 3-10% of patients with congenital heart disease. It results from the failure of the left anterior cardinal vein to degenerate during embryological development. Serious complications such as shock, angina and cardiac arrest have been described during catheterization in adults with a PLSVC. Since it frequently goes undiagnosed because of lack of symptoms when not accompanied by other anomalies, variations of the superior vena cava should be considered, especially when central venous catheterization via the subclavian or internal jugular vein is difficult. The embryological development, diagnosis, and clinical implications of a PLSVC are therefore reviewed in this article.
Granata
Antonio
A
Departments of Nephrology & Dialysis, Internal Medicine & Radiology, Vittorio Emanuele-Ferrarotto-S. Bambino Hospital, University of Catania, Catania,Italy. antonio.granata4@tin.it
Andrulli
Simeone
S
Fiorini
Fulvio
F
Logias
Francesco
F
Figuera
Michele
M
Mignani
Renzo
R
Basile
Antonio
A
Fiore
Carmelo Erio
CE
D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D033162:Incidental Findings; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging