Project description:Persistent left superior vena cava (PLSVC) is the most frequent abnormality in the general population with the frequency of 0.1% to 0.5%. It results from the failure of the involution of the left anterior cardinal vein. Right and Left SVC can coexist together in 80% to 90% of cases. Association of PLSVC with ano rectal malformation (ARM) is very rarely reported. Hence, here is a report of a unique case of PLSVC in a female neonate with ARM.
Project description:Persistent left superior vena cava (PLSVC) is a rare disorder which is asymptomatic and hence is usually discovered while performing interventions through the left subclavian vein. We present a case of a 78-year-old male who was undergoing elective placement of a permanent pacemaker for tachycardia - bradycardia syndrome with post-conversion pauses of up to nine seconds. After achieving access through the left subclavian vein the wire kept on going on the left side of the chest instead of crossing the midline to the right side. The wire was removed and contrast venography was done, PLSVC with dilated coronary sinus emptying into the right atrium was confirmed. There was some difficulty in passing the lead to the right ventricle even with the acute curve in the stylet. The sheath size was increased and a longer deflectable sheath was used and with the tip of the lead anteriorly the right ventricle was cannulated and the lead was affixed. There were good sensing and pacing parameters. Post procedure chest x-ray was done and the patient was discharged without any complications.
Project description:Persistent left superior vena cava is the most common congenital anomaly of thoracic venous return, which results when the left anterior cardinal vein fails to regress. A 41-year-old African American male with a history of an unspecified childhood cardiac murmur presented to the emergency department with congestive heart failure exacerbation revealing an incidental finding of a persistent left superior vena cava. Ultimately, he required implantable cardioverter defibrillator placement and cardiac transplantation assessment. In the setting of advanced device placement or cardiac transplantation, a persistent left superior vena cava warrants several important clinical considerations at a center capable of addressing the possibility of a right-sided approach and transplantation irregularities.
Project description:A 40-year-old man was admitted with necrotising fasciitis of the right thigh. Further workup to evaluate for an infectious source revealed an incidental finding of persistent left superior vena cava via transesophageal echocardiography. This finding was confirmed by cardiac MRI. During his hospitalisation, he also developed altered mental status which was found to be secondary to systemic emboli by a head MRI. The primary source of infection was likely his dental abscesses. He underwent intravenous antibiotic therapy for a total of 6 weeks and was then referred to a specialised vascular centre for further management of his congenital anomaly.
Project description:Background and purposeOur case report deals with the importance of detailed echocardiographic examination for differential diagnosis of coronary sinus dilation and development of abnormalities of great thoracic veins.Case presentationA 49-year-old man underwent transthoracic echocardiography for atypical chest pain. A dilated coronary sinus was found and venous contrast echocardiography raised the suspicion of absent right and persistent left superior vena cava. Transesophageal echocardiography showed absence of right superior vena cava. The echocardiographic findings were confirmed by upper venous digital subtraction cavography.Conclusioncombination of agenesia of right SVC and isolated persistent left SVC in adult patients is a very rare abnormality. Both clinicians and sonographers should be alerted to the possible presence of this combined venous anomaly. Transthoracic echocardiograpy - including agitated saline infusion to the antecubital vein - is an important diagnostic tool for accurate diagnosis of this congenital thoracic venous malformation.
Project description:Superior vena cava (SVC) syndrome is an uncommon but serious complication associated with chronic transvenous implanted leads. In the recent past, open-heart surgery combining lead extraction and epicardial implant was usually performed to reduce syndrome recurrences. We describe the case of a 78-year-old man successfully treated by percutaneous lead extraction associated with venous balloon angioplasty and reimplantation of leadless pacemaker. <Learning objective: Chronic vascular complications following lead implantation usually require surgical treatment, due to the need for subsequent epicardial implantation. Percutaneous lead extraction along with leadless pacing allowed effective non-surgical management of chronic complications of transvenous pacing.>.