PLSVC is usually a structural anomaly, present in 0.
PLSVC with absent RSVC is a rare congenital anomaly that can complicate the implantation of the permanent pacemaker lead.
The CVC was stopped till the exact variation in venous anatomy was confirmed and more importantly the location of the PLSVC opening identified if it was in right or left side of the heart.
5 The PLSVC has been found incidentally as an asymptomatic lone variation with coexistent cardiac anomalies such as Tetralogy of Fallot, septal defects and situs inversus.
Patients with benign PLSVC are mostly asymptomatic; however, the distorted venous anatomy can cause difficulties in catheter manipulation that may increase the risk of catheter misplacement, vessel injury and development of arrhythmias and even cardiac arrest.
But it may be symptomatic in patients with a PLSVC draining to left atrium that causes a hemodynamically significant right to left shunt with a variable degree of systemic cyanosis and clubbing in the absence of a RSVC.
In addition, some researchers suggested that patients with a PLSVC may become symptomatic due to arrhythmias through stretching of the atrioventricular node or His bundle by the dilated coronary sinus.
3D TEE full-volume image after cropping showed PLSVC
and dilated CS (Fig.
TTE in the apical 4-chamber axis demonstrating shows a severely dilated coronary sinus suggestive of a PLSVC PLSVC
--persitent left superior vena cava, TTE--transthoracic echocardiography