Department of Anatomy and Embryology, Ruhr University Bochum, Bochum, Germany.
Clin Anat. 2010 Apr;23(3):277-86. doi: 10.1002/ca.20945.
The relatively common persistent left superior caval vein (LSCV) is in most cases associated with doubling of the superior caval vein. A persistent LSCV with absent right superior caval vein (RSCV)-a rather rare event-was found during our course of gross anatomy. The LSCV drained into an enlarged coronary sinus, which was partly accompanied by an apparent "double" sinus of normal size draining into this enlarged coronary sinus. Histological and immunofluorescence studies using antibodies against smooth and cardiac muscle actins were performed. The terminal part of the LSCV near the opening into the right atrium contained cardiac actin as expected for a normal derivative of the left sinus horn. Previously only one case of doubled coronary sinus with LSCV has been reported and this abnormality was explained by splitting of the sinus. In our case, the partly doubled coronary sinus had the structure of coronary veins. Mechanical forces have been invoked for the obliteration of the LSCV. Therefore, we examined thirteen human embryos from 15 mm to 32 mm crown-rump length. In one embryo, we found a persistent LSCV together with an enormously enlarged left atrium. Contrary to previous suggestions our data indicate that during normal development a compression of the left anterior cardinal vein does not sufficiently explain the obliteration of the left and the persistence of the right vein. We therefore believe that beside a left dominated blood flow of head and arm, genes for left-right signaling may have to be taken into consideration.
相对常见的永存左上腔静脉（LSCV）在大多数情况下与上腔静脉的双重化相关。在我们的大体解剖学课程中发现了一种相当罕见的事件，即永存的 LSCV 伴右上腔静脉（RSCV）缺失。LSCV 汇入增大的冠状窦，部分伴有明显的“双”正常大小的窦汇入这个增大的冠状窦。进行了针对平滑肌和心肌肌动蛋白的抗体的组织学和免疫荧光研究。LSCV 在靠近右心房开口的末端部分含有心肌肌动蛋白，这是左窦角正常衍生物的预期表现。以前只报道过一例伴有 LSCV 的双倍冠状窦，这种异常是通过窦的分裂来解释的。在我们的病例中，部分双倍的冠状窦具有冠状静脉的结构。机械力被认为是 LSCV 闭塞的原因。因此，我们检查了 13 个人类胚胎，从 15 毫米到 32 毫米头臀长。在一个胚胎中，我们发现了一条永存的 LSCV 以及一个极度增大的左心房。与之前的建议相反，我们的数据表明，在正常发育过程中，左前主静脉的压迫不足以解释左静脉的闭塞和右静脉的持续存在。因此，我们认为，除了头部和手臂的左主导血流之外，还必须考虑到左右信号的基因。
