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Deepa Sasikumar, Kavasseri Mahadevan Krishnamoorthy, Sivasankaran Sivasubramanian, Arun Gopalakrishnan, Dibyaranjan Behera, Anomalous venous drainage: a rare case of cyanosis, European Heart Journal - Cardiovascular Imaging, Volume 17, Issue 9, September 2016, Page 977, https://doi.org/10.1093/ehjci/jew107
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A 7-year-old boy presented with cerebral abscess. He was found to be mildly cyanotic with an oxygen saturation of 86%. Transthoracic echocardiogram showed left atrial and left ventricular dilatation. The right superior vena cava (SVC) was shown to be draining into the left atrium, with normal drainage of inferior vena cava to right atrium (Panels A and B). No left superior vena cava was detected. The atrial septum was intact. The pulmonary veins were draining to left atrium. Contrast echocardiography, which consisted of injecting agitated saline in the right arm, showed opacification of the left atrium with no contrast in right atrium (Panel C; see Supplementary data online, Videos S1 and S2). Anomalous drainage of the right SVC in the left atrium is a very rare anomaly in the absence of associated congenital heart disease. Full segmental echocardiographic assessment with contrast echocardiography allows accurate detection of this anomaly. This lesion is associated with a high risk for paradoxical emboli and brain abscesses. Our patient recovered from his cerebral abscess and will undergo surgical rerouting of the right SVC to the RA.
