Double superior vena cava

Case contributed by Tawe Godwin Sale
Diagnosis certain

Presentation

Known case of atrial septal defect being prepared for surgery.

Patient Data

Age: 20 years
Gender: Male
ct

Left-sided superior vena cava coursing along the left mediastinum and draining into the right atrium via the coronary sinus. Contrast was administered through the left arm vein

2 cm interconnecting atrial septal defect superior. Associated markedly dilated right atrium, and to a lesser extent, the right ventricle. Dilated pulmonary trunk is seen (3.6cm).

The remaining demonstrated great vessels appear fairly normal: A short brachio-cephalic trunk is seen, the left common carotid artery and the left subclavian artery are normal in position.

Case Discussion

A left-sided superior vena cava (SVC) is the most common congenital venous anomaly in the chest. It can result in a right-to-left shunt. In most cases, it occurs simultaneously with a right superior vena cava giving rise to double superior vena cava.

Double SVC arises when there is failure of the embryonic left anterior cardiac vein to regress. Drainage is usually variable as it can be to the right atrium via the oblique vein of Marshall, coronary sinus, or the left atrium.

 A left-sided SVC is seen in 0.3-0.5% of the normal population and in ~5% of those with congenital heart disease.

The vast majority of cases are asymptomatic and the presence of the vessel is only identified incidentally during CT scanning of the chest as with this case.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.