A combined vascular anomaly including persistent left superior vena cava, left upper pulmonary vein, and coronary sinus.

Abstract

We report an incidental computed tomography (CT) finding of a persistent left superior vena cava (PLSVC) draining into the left upper pulmonary vein, accompanied by the coronary sinus (CS) connection to both the right atrium and the left upper pulmonary vein. A 57-year-old man underwent coronary CT angiography for bypass graft evaluation. An incidental PLSVC draining into the left upper pulmonary vein was detected. The coronary sinus had normal right atrial drainage but also connected to the left upper pulmonary vein. PLSVC usually drains into the right atrium and rarely into the left upper pulmonary vein. To our best knowledge, the anomaly of the coronary sinus connecting to both the left upper pulmonary vein and right atrium has not been previously reported. Although typically asymptomatic, right-to-left shunting may occur. Recognition of this rare anomaly is crucial before thoracic or electrophysiological procedures.