Heye Tobias, Wengenroth Martina, Schipp Anne, Johannes Dengler Thomas, Grenacher Lars, Werner Kauffmann Günter
Int J Cardiol. 2007 Apr 4;116(3):e103-5. doi: 10.1016/j.ijcard.2006.08.067. Epub 2006 Nov 13.
Here we report a rare case of the persisting left superior vena cava with simultaneous absence of the right superior vena cava. This central venous variation has been identified during a routine chest CT scan as follow-up after colonic cancer in an asymptomatic patient with no previous history of heart diseases. Morphological features of this variation are illustrated on axial CT images and 3D image reconstructions. This anomaly occurs in 0.1% of the general population. In presence with the right superior vena cava it is the most common anatomical variation in the central venous system with a reported occurrence of 0.2-8%. Such condition can be associated with additional congenital cardiovascular malformations and heart diseases or rhythm abnormalities. Diagnosis can be difficult and is often achieved incidentally since hemodynamics in these patients can be normal and clinical symptoms are mostly absent. Important clinical implications include difficulties in central venous access or cardiac pacemaker placement as well as management consequences in cardiothoracic surgery. In conclusion clinicians should be aware of this anomaly and their clinical relevance to avoid possible complications.
在此，我们报告一例罕见的持续性左上腔静脉伴右上腔静脉缺如的病例。这种中心静脉变异是在一名无症状、既往无心脏病史的结肠癌患者进行常规胸部CT扫描随访时发现的。轴向CT图像和三维图像重建展示了这种变异的形态学特征。这种异常在普通人群中的发生率为0.1%。与右上腔静脉并存时，它是中心静脉系统中最常见的解剖变异，报告发生率为0.2% - 8%。这种情况可能与其他先天性心血管畸形、心脏病或节律异常有关。诊断可能困难，且常为偶然发现，因为这些患者的血流动力学可能正常且大多无临床症状。重要的临床意义包括中心静脉通路或心脏起搏器植入困难以及心胸外科手术中的处理后果。总之，临床医生应了解这种异常及其临床相关性，以避免可能的并发症。
