Open Access

CASE REPORT

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

by Naveed Rabbani^1,*, 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.

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Keywords

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