Persistent Left Superior Vena Cava with the Absence of the Right Superior Vena Cava and Atrial Appendage: Complex Pacemaker Implantation in a Patient Presenting with a Rare Vascular Anomaly

• Published in: Internal Medicine Vol. 63; no. 10; pp. 1373 - 1376
• Main Authors: Hata, Toshika, Kato, Koichi, Kamiya, Kenichi, Okuyama, Yusuke, Fujii, Yusuke, Yagi, Noriaki, Ozawa, Tomoya, Nakagawa, Yoshihisa
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15-05-2024; Japan Science and Technology Agency
• Subjects: absence of superior vena cava; Aged; Atrial Appendage - abnormalities; Atrial Appendage - diagnostic imaging; Case Report; Computed tomography; Female; Humans; isolated persistent left superior vena cava; Male; pacemaker implantation; Pacemaker, Artificial; Pacemakers; Persistent Left Superior Vena Cava - complications; Persistent Left Superior Vena Cava - diagnostic imaging; sick sinus syndrome; Sick Sinus Syndrome - therapy; Tomography, X-Ray Computed; Vascular Malformations - complications; Vascular Malformations - diagnosis; Vascular Malformations - diagnostic imaging; Vena Cava, Superior - abnormalities; Vena Cava, Superior - diagnostic imaging; case report; absence of superior vena cava; isolated persistent left superior vena cava; pacemaker implantation; sick sinus syndrome
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.2391-23

A persistent left superior vena cava (PLSVC) is a commonly observed anatomical anomaly that is frequently detected incidentally via computed tomography (CT) imaging. However, the occurrence of a PLSVC with a right superior vena cava (RSVC) defect, also known as "isolated PLSVC," is a much rarer anomaly. This peculiar malformation can lead to sinoatrial dysfunction, thus necessitating pacemaker implantation, which requires delicate manipulation due to various anatomical complexities. We herein present a case of a sick sinus syndrome with this rare anomaly, which required special consideration when performing pacemaker lead placement.