Written by Judith Buckland, MBA, FASE, RDCS

Persistent Left Superior Vena Cava (PLSVC): Anatomy and blood flow

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

Subclavian Anatomy

Normal Anatomy

  • Right subclavian and left subclavian merge into the Superior Vena Cava (SVC)
  • Normal flow – Superior Vena Cava to Right Atrium
Normal SVC anatomy versus

Abnormal Anatomy

  • 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
Persistent Left Superior Vena Cava PLSVC anatomy

PLSVC Blood Flow

Blood flows from the left SVC into the coronary sinus and into the right atrium.

blood flow with persistent left superior vena cava


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.

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2.5 CMEs The Why and How of Echo Bubble Studies

  • Preparation and administration of agitated saline
  • Tips for improving imaging
  • PFOs
  • Persistent Left Superior Vena Cava
  • Pulmonary Arteriovenous Malformation
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Brianan Byrne
This is so weird, I signed up to you blog as its amazing to see helpful tips..I only found a PLSVC yesterday on a patient, strangely cooincidental!!
tahir mosa sahib
after compliments for all of you it is excellent informations in echo and super nice way of explanation .i like to thank you to much do have MCQS on echocardiography

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