J Thorac Cardiovasc Surg 1994;108:387-388
© 1994 Mosby, Inc.
Case report of isolated and abnormal drainage of right superior vena cava into left atrium
Kamal Raissi, MD,
Mahmood Meraji, MD,
Hassan M. Sadeghi, MD,
S. H. Firoozabady, MD
Heart Hospital
Valy-Asr-Ave.
Tehran, Iran
To the Editor:
This case report describes the diagnosis and successful surgical treatment of abnormal venous drainage of the head and neck into the left atrium of a 9-year-old girl After extensive review of the literature, 
1-3 we believe this is the sixth case of this rare congenital anomaly and the first case described as pure drainage of a right superior vena cava into the left atrium. Table I shows results of oximetry. Figs. 1 and 2 show the results of injection of contrast material into the heart. The radiopaque material ended up in the aorta.
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Fig. 1. Radiopaque material injected into pulmonary artery. At recirculation, it has filled left atrium (LA), right superior vena cava (SVC), left ventricle, and aorta (Ao).
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Fig. 2.A, Before operation. Sequential scintiscans show the tracer entering the left atrium and left ventricle via the right superior vena cava. B,After operation. Series of first-pass images shows normal segregation of activity within the heart chambers. The tracer is injected from the same arm entering the right superior vena cava and filling the right atrium and right ventricle.
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A 9-year-old white girl was referred to this center because of cyanosis and underwent an extensive workup. Her operation was performed through a standard median sternotomy incision, without cardiopulmonary bypass. A direct anastomosis of the superior vena cava into the right atrium was accomplished with the aid of excluding clamps. The patient tolerated the procedure well and was discharged from the hospital in good condition.
References
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Anderson RH, Fischer DR, Zuberbuhler J. Anomalous systemic venous return. In: Anderson RH, Macartney FJ, Shinebourne EA, Tynan M, eds. Paediatric cardiology. Vol. 1. London: Churchill Livingstone, 1987:503.
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Lucas RV, et al. Anomalous venous connection, pulmonary and systemic. In: Adams FH, Emmanouilides GCE, Reimenschneider TA, eds. Moss's heart disease in infants, children, and adolescents. 4th ed. Baltimore: Williams & Wilkins, 1989:609.
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Kirsch WM, Carlsson E, Hartmann AF Jr. A case of anomalous drainage of the superior vena cava into the left atrium. J THORAC CARDIOVASC SURG 1961;41:550-6.
