Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(04): 413-416
DOI: 10.4103/ijri.IJRI_313_16
Thoracic/ Cardiac

Levoatrial cardinal vein with normal left ventricle: A forgotten cause of pulmonary arterial hypertension

Onkar B Auti
Department of Radio-diagnosis, Narayana Health City, Bengaluru, Karnataka, India
,
Varun Shetty
Department of Cardiovascular Surgery, Narayana Health City, Bengaluru, Karnataka, India
,
Vinay Belaval
Department of Radio-diagnosis, Narayana Health City, Bengaluru, Karnataka, India
,
Vimal Raj
Department of Radio-diagnosis, Narayana Health City, Bengaluru, Karnataka, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
Also available at
  PDF Download Permissions and Reprints

Abstract

Levoatrial cardinal vein (LACV) is anomalous connection between left atrium or pulmonary veins and systemic veins such as innominate vein or superior vena cava. This persistence of splanchnic circulation occurs when there is left-sided obstructive cardiac lesions such as hypoplastic left heart or mitral atresia. In this report we present three cases of LACV with well-developed left heart, without any obstructive lesions. All our cases presented with pulmonary arterial hypertension (PAH) and had associated intracardiac shunt such as ventricular/atrial septal defect and supracardiac partial anomalous pulmonary venous connection. Apart from the above shunts, LACV contributed to PAH in these cases. It is important to detect and report LACV as this may require surgical correction along with other defects. If LACV goes undetected during imaging workup, it may cause persistent PAH postoperatively.

Keywords

Hypoplastic left heart - levoatrial cardinal vein - mitral atresia - pulmonary arterial hypertension


Publication History

Article published online:
27 July 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Edwards JE, DuShane JW. Thoracic venous anomalies I. Vascular connection of the left atrium and the left innominate vein (levoatriocardinal vein) associated with mitral atresia and premature closure of the foramen ovale II. Pulmonary veins draining wholly into the ductus arteriosus. Arch Pathol 1950;49:517-37.
  • 2 McIntosh CA. Cor biatriatum triloculare. Am Heart J 1926;1:735-44.
  • 3 Bernstein HS, Moore P, Stanger P, Silverman NH. The levoatriocardinal vein: Morphology and echocardiographic identification of the pulmonary-systemic connection. J Am Coll Cardiol 1995;26:995-1001.
  • 4 Odemis E, Akdeniz C, Saygili OB, Karaci AR. Levoatriocardinal vein with normal intracardiac anatomy and pulmonary venous return. Ann Pediatr Cardiol 2011;4:183-5.
  • 5 Kaneda T, Onoe M, Matsuda M, Moriwaki S, Mori N. Patent levoatrial cardinal vein without left heart hypoplasia. Ann Thorac Surg 2006;81:740-2.
  • 6 Fujiwara K, Naito Y, Komai H, Noguchi Y, Nishimura Y, Uemura S, et al. Tetralogy of Fallot with levoatrial cardinal vein. Pediatr Cardiol 1999;20:136-8.
  • 7 Genc B, Solak A, Sahin N, Gur S, Ozturk A, Kalaycioglu S. Multidetector computed tomography findings of an asymptomatic levoatrial cardinal vein with an interatrial course. Folia Morphol 2013;72:274-7.
  • 8 Iga K, Hori K. Abnormal venous connection between the left upper pulmonary vein and the left brachiocephalic vein associated with rheumatic combined valvular heart disease. Heart Vessels 1990;5:113-6.
  • 9 Ciliberti P, Taylor AM, Yates R, Giardini A. Occlusion of persistent levoatrial cardinal vein without left heart hypoplasia utilizing an Amplatzer device. Eur Heart J Cardiovasc Imaging 2013;14:857.