Persistent left superior vena cava associated with giant coronary sinus/Dev koroner sinüs ile iliskili persistan sol vena cava süperiyor

A 70-year-old male patient was admitted to the cardiology outpatient clinic with complaint of shortness of breath during exertion. He had history of hypertension, permanent atrial fibrillation and coronary artery bypass graftsurgery. Transthoracic echocardiography revealed normal findings except a severely dilated coronary sinus suggestive of a persistent leftsuperior vena cava (PLSVC) in apical 4-chamber view (Fig. 1A, B., Video 1. See corresponding video/movie images at www. anakarder.com). Contrast study from the leftantecubital vein showed prior contrast enhancement of this giant coronary sinus before the right atrium (Video 2. See corresponding video/movie images at www.anakarder. com). However, contrast study from the right antecubital vein showed prior contrast enhancement of the right atrium before the coronary sinus (Video 3. See corresponding video/movie images at www.anakarder. com). For further anatomical analysis of bypass grafts and possible associated anomalies, multislice computed tomography (CT) was performed. CT showed patent bypass grafts and the PLSVC draining into a giant coronary sinus (5.1 cm) (Fig. 1 C, D, E and F). The patient was prescribed by angiotensin-converting enzyme inhibitors, beta-blockers, warfarin, statins and diuretics. He was discharged and called for controls.

Video 1. TTE in the apical 4-chamber axis demonstrating shows a severely dilated coronary sinus suggestive of a PLSVC

PLSVC - persitent leftsuperior vena cava, TTE - transthoracic echocardiography

Video 2. Contrast study from the leftantecubital vein shows prior contrast enhancement of this giant coronary sinus before the right atrium

Video 3. Contrast study from the right antecubital vein shows prior contrast enhancement of the right atrium before the coronary sinus