Presentation
Incidental finding on CT.
Patient Data
the right SVC is formed by the right brachiocephalic vein
the left SVC is formed by the left brachiocephalic vein and drained in the coronary sinus
There is an accessory hemiazygos vein draining into the left-sided SVC.
Incidental gallbladder calculus (chol
Case Discussion
CT features a double SVC with an accessory hemiazygos vein draining into the left-sided SVC (incidental finding).
A left-sided superior vena cava (SVC) is the most common congenital venous anomaly in the chest, and in a minority of cases can result in a right-to-left shunt. It is seen in 0.3-0.5% of the normal population and in ~5% of those with congenital heart disease.
It is only seen in isolation in 10% of cases since the vast majority are accompanied by a normal right-sided SVC, termed SVC duplication (as in this case).
The vast majority of cases are asymptomatic and the presence of the vessel is only identified incidentally during CT scanning of the chest (as in this case).
Other configurations are possible, with the left superior intercostal vein forming a communication between the left SVC and the accessory hemiazygos vein forming a left-sided azygos arch.
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