Persistent left superior vena cava with absent right superior vena cava in adults: CT and clinical findings

Purpose Persistent left superior vena cava (PLSVC) with absent right superior vena cava (ARSVC) is rare. We evaluated CT and clinical findings of adults with ARSVC. Materials and methods Our study included 11 adults with ARSVC (mean age, 63 ± 17 years). We evaluated CT findings of the azygos vein system and coronary sinus (CS) using thin slice data of > 64 MDCT. Arrhythmia and congenial heart disease were assessed. We compared the CS diameters between the ARSVC group and the control group of 120 adults with normal vena cava (mean age, 60 ± 4 years). Results Adults with ARSVC had no azygos vein arch and the hemiazygos vein continued to PLSVCs via the superior intercostal vein. Eight adults had arrhythmia including conduction disturbance and one arrhythmia was associated with atrial septal defect. All adults with ARSVC had dilated CS larger than 11 mm. The mean diameter of the CS in the ARSVC group was 18.4 mm, and that of the control group was 6.8 mm. CS diameter in the ARSVC group was larger than that in the control group ( p < 0.001). Conclusion Adults with ARSVC had dilated CS and no azygos vein arch. Four adults had conduction disturbance.