Prenatal Diagnosis of Persistent Left Superior Vena Cava and its Clinical Significance

Abstract

Background:Persistent leftsuperior venacava(PLSVC) is a variantof systemic venous return which is observed in 0.3% of autopsies in the general population andin 4-8% of patients withcongenital heartdisease.Aims:Toevaluate associated cardiac, extracardiac andchromosomal anomalies inprenatally diagnosed cases ofPLSVC andtoreview their outcome.Study Design: Retrospective comparative study.Methods:Thedataofpatients witha prenatal diagnosis ofPLSVC between May2008 andJanuary 2013 werereviewed retrospectively. Results:Dataof 31cases werereviewed. Fifteen (48.4%) cases were associated withcardiac defects and17(54.8%) cases hadassociatedextracardiac sonographic orpostpartum findings. Two fetuses had karyotype anomalies. Outcome wassignificantly more favorable in cases notassociated withcardiac defects incomparison tothose as-sociated withcardiac anomalies (84.6% vs.33.3%, p=0.009). Allcases withisolated PLSVC survived, while among thecases associated with extracardiac anomalies, withcardiac anomalies andwithbothextra-cardiac andcardiac anomalies, thesurvival ratewas75%, 50%and 22.2%, respectively. Themostfrequent group of cardiac anomalies as-sociated withPLSVC wasseptal defects and VSD wasthemostcom-mon heart defect individually, being observed in nine fetuses.Conclusion:Prenatally diagnosed PLSVC is associated withcardiac andextracardiac anomalies in themajority of cases. Outcome is sig-nificantly worse if PLSVC is associated witha cardiac defect, andthe prognosis is excellent in isolated cases.