Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-24T15:54:52.672Z Has data issue: false hasContentIssue false

Persistence of the left superior caval vein: can it potentiate obstructive lesions of the left ventricle?

Published online by Cambridge University Press:  19 August 2008

Gabriella Agnoletti*
Affiliation:
Divisione di Cardiologia eOspedali Riuniti, Bergamo, Italy
Francesco Annecchino
Affiliation:
Cardiochirurgia, Ospedali Riuniti, Bergamo, Italy
Laura Preda
Affiliation:
Divisione di Cardiologia eOspedali Riuniti, Bergamo, Italy
Adele Borghi
Affiliation:
Divisione di Cardiologia eOspedali Riuniti, Bergamo, Italy
*
Gabriella Agnoletti, via C. Battisti, 43C, Bovezzo (BS), Italy. Tel: 39 30 2712002; Fax: 39 35 400491

Abstract

Recent evidence has suggested that persistence of the left superior caval vein is associated with a high incidence of obstructive lesions of the left heart. To shed more light on this issue 1085 patients with congenital heart disease were studied retrospectively, with the aim of estimating the prevalence of a persistent left superior caval vein and its associated anomalies, focusing attention on obstructive lesions in the left and right ventricles. Patients with isomerism of the atrial appendages, or hypoplastic left heart syndrome, were excluded. A persisting left superior caval vein was present in 57 patients (5.2%). The overall incidence of obstructive lesions of the left heart was higher in patients with than in those without a persistent left superior caval vein (31.6 versus 7.8%, p < 0.001). Relative hypoplasia of the left ventricle was also higher in patients with persistent left superior caval vein (14 versus 0.8%, p < 0.001). The obstructive lesions found in the left heart, compared with the number in those without a left caval vein, were: mitral stenosis, 5.2 versus 0.7%; subaortic stenosis, 5.3 versus 0.9%; aortic coarctation, 17.5 versus 5.8% (p < 0.01); all of these in association, 3.5 versus 0.4%. In contrast, the incidence of obstructive lesions of the right heart was similar in the two groups of patients. It is concluded that persistence of the left superior caval vein can perturb the normal development of the left ventricle, being strongly associated with obstructions to left ventricular inflow and outflow.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Cochrane, AD, Marath, A, Mee, RB. Can a dilated coronary sinus produce left ventricular inflow obstruction? An unrecognized entity. Ann Thorac Surg 1994; 58: 11141116.CrossRefGoogle ScholarPubMed
2.MacEdo, AJ, Oosthoek, PW, Wenink, ACG, Bartelings, MM. Does persistent left superior vena cava to coronary sinus influence the growth of the left heart in the fetus? Cardiol Young 1996: 6; abstract P101.Google Scholar
3.Carpentier, A, Branchini, B, Cour, JC, Asfaou, F, Villani, M, Deloche, A, Relland, J, D'Allaines, CI, Blondeau, PH, Piwnica, A, Parenzan, L, Brom, G. Congenital malformations of the mitral valve in children. J Thorac Cardiovasc Surg 1976; 72: 854866.CrossRefGoogle ScholarPubMed
4.Hossack, KF, Neutze, JM, Lowe, JB, Barrat-Boyes, BG. Congenital valvar aortic stenosis: natural history and assessment for operation. Br Heart J 1980; 43: 561573.Google Scholar
5.Ho, SY, Anderson, RH. Coarctation, tubular hypoplasia and the ductus arteriosus. Br Heart J 1979; 41: 268270.Google Scholar
6.Rhodes, LA, Colan, SD, Perry, SB, Jonas, RA, Sanders, SP. Predictors of survival in neonates with critical aortic stenosis. Circulation 1991; 84: 23252335.CrossRefGoogle ScholarPubMed
7.Buirski, G, Jordan, SC, Joffe, HS, Wilde, P. Superior vena caval abnormalities: their occurrence rate, associated cardiac abnormalities and angiographic classification in a paediatric population with congenital heart disease. Clin Radiol 1986; 37: 131138.CrossRefGoogle Scholar
8.Parikh, SR, Prasad, K, Lyer, RN, Desai, N, Mohankrishna, L. Prospective angiographic study of the anomalies of systemic venous connection in congenital and acquired heart disease. Cathet Cardiovasc Diagn 1996; 38: 379386.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
9.Blieden, LCScneeweiss, A, Deutsch, V, Neufeld, HN. Anomalous venous connection from the left atrium or to a pulmonary vein. Am J Roentol 1977; 129: 937938.CrossRefGoogle ScholarPubMed
10.Kutsche, LM, van Mierop, LHS. Pulmonary atresia with and without ventricular septal defect: a different etiology and pathogenesis for the atresia in the two types? Am J Cardiol 1983; 51: 932935.Google Scholar
11.Rudolph, AM, Heyman, MA, Spitznas, U. Hemodynamic considerations in the development of narrowing of the aorta. Am J Cardiol 1972; 30: 514525.Google Scholar