Open Access

CASE REPORT

Positional Hypoxemia from Persistent Left Superior Vena Cava Draining to the Left Atrium

Naveed Rabbani1,*, Sarah Hofman DeYoung2, Ronald L. Gibson2, Jeffrey Conwell1, Jason F. Deen1
1 Division of Pediatric Cardiology, Seattle Children’s Hospital and the University of Washington School of Medicine, Seattle, WA 98105, USA
2 Division of Pediatric Pulmonary and Sleep Medicine, Seattle Children’s Hospital and the University of Washington School of Medicine, Seattle, WA 98105, USA
* Corresponding Author: Naveed Rabbani. Email:

Congenital Heart Disease 2020, 15(4), 197-201. https://doi.org/10.32604/CHD.2020.011527

Received 15 May 2020; Accepted 30 July 2020; Issue published 07 September 2020

Abstract

Persistent left superior vena cava (PLSVC) is a relatively common congenital venous anomaly that typically drains into the coronary sinus without hemodynamic significance. Rarely a PLSVC drains directly into the left atrium, forming a right-to-left shunt that can result in hypoxemia and potential paradoxical embolism. We present the case of a 2-year-old medically complex child on chronic mechanical ventilation with eventual diagnosis of episodic hypoxemia due to a PLSVC draining into the left atrium with position-dependent venous flow. The lesion was identified with contrast echocardiography and cardiac MRI. Subsequent occlusion with a vascular plug resulted in resolution of the child’s positional hypoxemia. This case extends available reports for this rare presentation of PLSVC and serves as a reminder of the importance of injection site in contrast echocardiography.

Keywords

Venous anomalies; echocardiography; congenital heart disease; right-to-left shunting; hypoxemia

Cite This Article

Rabbani, N., DeYoung, S. H., Gibson, R. L., Conwell, J., Deen, J. F. (2020). Positional Hypoxemia from Persistent Left Superior Vena Cava Draining to the Left Atrium. Congenital Heart Disease, 15(4), 197–201.



This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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