Persistent Left Superior Vena Cava (PLSVC) creates a connection from the SVC to the coronary sinus. It is something we do not routinely see on echo but is always a great catch when we do see it! This week we will review the subclavian anatomy and blood flow of a PLSVC.
Persistent Left Superior Vena Cava (PLSVC)
PLSVC is an isolated anomaly with minimal hemodynamic and clinical significance. That said, there is a significant association with rhythm disturbances and other congenital cardiovascular abnormalities.
Often discovered follows the finding of an abnormally positioned catheter, pacemaker, or internal defibrillator lead
If central venous catheter’s tip is in the left paramediastinal region – think PLSVC
Confirm the presence of a PLSVC to rule out catheter perforation or migration
Right subclavian and left subclavian merge into the Superior Vena Cava (SVC)
Normal flow – Superior Vena Cava to Right Atrium
Various forms of persistent left superior vena cava exist, all with the left and right subclavians separating and draining into a left and right superior vena cava. The left superior vena cava (LSVC) drains directly into the coronary sinus.
PLSVC flow = Left Superior vena cava into the VC to the coronary sinus
PLSVC Blood Flow
Blood flows from the left SVC into the coronary sinus and into the right atrium.
This week we reviewed the anatomy and blood flow of a persistent left superior vena cava (PLSVC). Next week we will review how this presents during an echo bubble study.