Mi ZY, He G, Gao HL, Li C. Persistent left superior vena cava in right hemiarch replacement under deep hypothermic circulatory arrest: A case report. World J Clin Cases 2023; 11(32): 7858-7864 [PMID: 38073687 DOI: 10.12998/wjcc.v11.i32.7858]
Corresponding Author of This Article
Chao Li, MM, MMed, Associate Chief Physician, Associate Professor, Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, No. 439 Xuanhua Road, Yongchuan District, Chongqing 402160, China. lichao8080@126.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 16, 2023; 11(32): 7858-7864 Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7858
Persistent left superior vena cava in right hemiarch replacement under deep hypothermic circulatory arrest: A case report
Ze-Yu Mi, Gang He, Hong-Li Gao, Chao Li
Ze-Yu Mi, Gang He, Chao Li, Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
Hong-Li Gao, Department of Ultrasound Medicine, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
Author contributions: Mi ZY contributed to manuscript writing and editing, and data collection; He G and Gao HL contributed to data analyses; Li C contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported byTechnology Innovation and Application Development Project of Chongqing, No. 2021yc-cxfz30016.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao Li, MM, MMed, Associate Chief Physician, Associate Professor, Department of Cardiac Surgery, Yongchuan Hospital of Chongqing Medical University, No. 439 Xuanhua Road, Yongchuan District, Chongqing 402160, China. lichao8080@126.com
Received: September 21, 2023 Peer-review started: September 21, 2023 First decision: October 9, 2023 Revised: October 17, 2023 Accepted: November 3, 2023 Article in press: November 3, 2023 Published online: November 16, 2023
Abstract
BACKGROUND
Persistent left superior vena cava (PLSVC), a relatively rare thoracic vascular malformation, can inconvenience perfusionists and operators when encountered during deep hypothermic circulatory arrest (DHCA).
CASE SUMMARY
Herein, we describe the case of a patient with concurrent giant aortic arch aneurysm, aortic stenosis, and PLSVC. To treat these conditions, we performed right hemiarch and aortic valve replacements under DHCA. Notably, we applied “bilateral superior vena cava retrograde cerebral perfusion (RCP)” for cerebral protection, which significantly optimized the surgical procedure and reduced the risk of postoperative complications. The patient was discharged 14 d after surgery with no complications.
CONCLUSION
Surgical intervention for PLSVC under DHCA can be performed using the bilateral superior vena cava RCP approach.
Core Tip: Persistent left superior vena cava (PLSVC) is a malformation that can coexist with the right superior vena cava without causing an imbalance in the hemodynamics, thereby concealing its detection during clinical consultation. We describe the case of a patient with an aortic arch aneurysm who also had PLSVC. When replacing the right hemiarch under deep hypothermic circulatory arrest, we utilized a “bilateral superior vena cava retrograde cerebral perfusion (RCP)” approach to PLSVC. The patient was discharged 14 d postoperatively without any complications. To the best of our knowledge, RCP via the bilateral superior vena cava has not previously been reported.
