Sr. Parikh et al., PROSPECTIVE ANGIOGRAPHIC STUDY OF THE ABNORMALITIES OF SYSTEMIC VENOUS CONNECTIONS IN CONGENITAL AND ACQUIRED HEART-DISEASE, Catheterization and cardiovascular diagnosis, 38(4), 1996, pp. 379-386
Angiographic definition of systemic venous connections was obtained pr
ospectively in 780 consecutive patients with congenital heart disease
and 102 patients with acquired valvular heart disease undergoing cardi
ac catheterization. Attempts were made to enter the innominate vein an
d perform a balloon occlusion angiogram in each patient, In patients w
ith congenital heart disease, bilateral superior vena cava were presen
t in 32/771 patients (similar to 4%) with levocardia and 3/9 patients
with dextrocardia, Among patients with bilateral superior vena cava (n
=35), an innominate vein of variable size that could be entered was pr
esent in six patients, Small tributaries connecting the right and left
superior vena cava were found and entered in six patients, The superi
or vena cava was entered via its connection to morphologic left atrium
in five patients and via the coronary sinus in 17 patients, Abnormali
ties of the inferior vena cava were seen in 7/780 patients, The follow
ing abnormalities of the inferior vena cava were noted: azygous contin
uation of rightsided inferior vena cava in levocardia-3 patients, hemi
azygos continuation of the leftsided inferior vena cava in levocardia-
1 patient, azygos continuation of the leftsided inferior vena cava in
dextrocardia-1 patient, interruption of inferior vena cava below the l
iver with a plexus of veins joining the azygos vein-1 patient, and an
inferior vena cava draining into the leftward aspect of the common atr
ium-1 patient. Abnormalities of the systemic venous connections were s
een in 2/102 patients with acquired heart disease: bilateral superior
vena cava in 1 patient and bilateral inferior vena cava in 1 patient,
Conclusions: Abnormalities of systemic venous connections were seen in
similar to 5% patients with congenital heart disease and similar to 2
% patients with acquired heart disease, Small tributaries or an innomi
nate vein of variable size often connect left and right superior vena.
Contrast material can be injected into these connections to document
the presence of bilateral superior vena cava, (C) 1996 Wiley-Liss, Inc
.