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Systemic Veins of the Thorax.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
The right and leftsuperior intercostal veins are often seen on CT sections, and these should not be confused with lung, pleural or mediastinal pathology. These veins may become dilated in heart failure, with obstruction of the SVC, innominate veins or the IVC. With an azygos lobe, the right superior intercostal vein follows an anomalous course through the posterior aspect of the azygos fissure. The superior intercostal veins may also be dilated with azygos or hemiazygos continuation of the IVC, hypoplastic innominate veins, a persistent left SVC, and anomalous pulmonary venous return.
Respiratory system
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Intercostal a. + v. – Ant. intercostal a. (1–7 from int. thoracic a., and 8–10 from musculophrenic a.)– Post. intercostal a. (1–2 from branch of costocervical trunk of second part of subclavian a., and 3–11 from subcostal a. of aorta)– Ant. intercostal v. (venae comitantes of int. thoracic a.)– Post. intercostal v. (1 to BCV, 2–3 from superior intercostal vein → drain to arch of azygos on RHS, BCV on LHS, and 4–11 to azygos veins)
Development and anatomy of the venous system
Published in Peter Gloviczki, Michael C. Dalsing, Bo Eklöf, Fedor Lurie, Thomas W. Wakefield, Monika L. Gloviczki, Handbook of Venous and Lymphatic Disorders, 2017
The axillary vein begins at the lower border of the teres major, which corresponds with the lateral border of the scapula on an anteroposterior chest roentgenogram. At the outer border of the first rib, it becomes the subclavian, which ends at the medial border of the scalenus anterior muscle, where it joins the internal jugular vein to form the brachiocephalic vein. The brachiocephalic (innominate) vein begins behind the sterno-clavicular joint. The left brachiocephalic vein descends obliquely to join the right one. Constant tributaries of the brachiocephalic vein are the vertebral, internal thoracic, and inferior thyroid veins. The superior intercostal vein drains the upper intercostal veins and opens into the brachiocephalic vein on the left, whereas on the opposite side it joins the azygos vein.
Persistent Left Superior Vena Cava: Why is Prenatal Diagnosis Important?
Published in Fetal and Pediatric Pathology, 2022
Ayşe Keleş, Osman Yılmaz, Gülşah Dağdeviren, Özge Yücel Çelik, Aykan Yücel, Dilek Şahin
Persistent left superior vena cava (PLSVC) is the most common variation of the thoracic venous system [1,2]. It is found in 0.3%–0.5% of the general population and 4%–8% in those with congenital heart disease (CHD) [3,4]. In the embryonic period, anterior cardinal veins perform the venous drainage of the cephalic region and upper extremity. Except for a small part that constitutes the left superior intercostal vein, the left anterior cardinal vein regresses in the eighth week of embryogenesis. Failure of this regression results in PLSVC [4,5]. In most cases, the right and left superior vena cava coexist. The specific combination of a persistent LSVC and non-right superior vena cava was reported to be 0.05% in an autopsy series [6,7]. PLSVC typically empties into the right atrium via the coronary sinus, but may empty directly into the left atrium [8].
Retroesophageal left brachiocephalic vein in tetralogy of fallot: an anomalous course depicted on computed tomography angiography
Published in Acta Cardiologica, 2022
Mansi Verma, Rishabh Khurana, Amarinder Singh Malhi, Sanjeev Kumar, Shyam S. Kothari
The LBCV normally courses obliquely downwards anterosuperior to aortic arch and its branches and joins the right BCV to drain into SVC. Left BCV coursing posterior to oesophagus is rare with incidence of ∼ 0.19% in association with congenital heart diseases [1]. The various cardiovascular associations include VSD with or without pulmonary atresia, right aortic arch and patent ductus arteriosus [1]. The retroesophageal course of left BCV can be associated with genetic anomalies including 22q11 deletion. Hence, identification of this anomaly suggests the need for genetic testing. The proposed mechanism for such an anomalous course is the interruption of superior capillary plexus between right and left anterior cardinal veins with failure of development of alternative inferior capillary plexus. Instead, the connection between accessory hemizygous and left superior intercostal vein persists [1]. The identification of this anomalous course is important for clinicians as its accidental manipulation during posterior mediastinal surgeries can lead to intraoperative bleeding. It can also lead to technical difficulties during insertion of transvenous pacemaker and central venous line via a left arm approach [2]. This case highlights the role of computed angiography in depicting anomalous venous anatomy which can have potential clinical implications.
Insertion of a totally implantable venous access port in a patient with persistent left superior vena cava (PLSVC)
Published in Acta Chirurgica Belgica, 2018
Julie Van Walleghem, Sofie Depuydt, Stijn Schepers
Persistent left superior vena cava (PLSVC) is the most common embryological malformation of the central venous system, reported in 0.3–0.5% of the general population [1]. Usually a PLSVC is asymptomatic and an incidental finding during placement of a central venous access device; however, patients are at increased risk of developing cardiac arrhythmias, due to the associated anomalous configuration of the embryological conductive tissue. Given the aging patient population and growing use of central venous access devices, physicians will be increasingly confronted with anatomical variations of the cardiac venous return. The existence of a PLSVC is suggested by periprocedural fluoroscopy that shows a left paramediastinal guidewire pathway after an uncomplicated venous puncture, nonetheless the presence of a large left superior intercostal vein, accessory hemiazygos vein, internal mammary vein or the occurrence of a venous perforation can lead to a similar finding.