Sitüs inversüs totalis ve çift superior vena kava: Nadir bir olgu

Situs inversus totalis (SİT) ve çift superior vena kava (SVK) nadir görülen  Konjenital anomalilerdir. Olguların çoğunluğu başka nedenlerle görüntülemede tesadüfen teşhis edilir. Diğer kardiyak anomalilerle birlikte olmadıkça çift SVK genellikle asemptomatiktir. 22 yaşındaki kadın hasta öksürük, baş ağrısı, halsizlik ve nefes darlığı şikayetleri ile kardiyoloji kliniğine başvurdu. 7 yıl önce atriyal septal defekt ve ventriküler septal defekt cerrahi onarım öyküsü olan hasta pulmoner emboli ve pulmoner hipertansiyon tanısı ile hastaneye yatırıldı. Göğüsün kontrastlı çok kesitli bilgisayarlı tomografisi (BT) kliniğimizde çekildi. BT, SİT ile çift SVK’ı gösterdi. Çift SVK’nın sağ SVK’sı sol atriuma drene idi. Kalp anomalilerinin eşlik ettiği anormal venöz bağlantı varyasyonları ekokardiyografi ve BT ile kombine görüntüleme yaklaşımıyla ameliyattan önce tam olarak tanımlanmalıdır.

Situs inversus totalis with double superior vena cava: An unusual case report

Situs inversus totalis (SIT) with double superior vena cava (SVC) is a rare congenital anomaly. Most cases are diagnosed incidentally after imaging for other reasons. Double SVC is usually asymptomatic, unless associated with other cardiac anomalies. A 22-year-old female patient with the complaints of cough, headache, weakness, and shortness of breath was admitted to the cardiology department. The patient, who was hospitalized with a diagnosis of pulmonary embolism and pulmonary hypertension, had a history of surgical repair of atrial septal defect and ventricular septal defect 7 years ago. Contrast-enhanced multislice computed tomography (CT) of the chest was obtained in our department. CT demonstrated SIT with double SVC, with the right SVC draining into the left atrium. The variations of anomalous venous connections accompanying cardiac anomalies should be fully defined before surgery with a combined imaging approach with echocardiography and CT.

___

  • 1. Sun XY, Qin K, Dong JH, Li HB, Lan LG, Huang Y, et al. Liver Transplantation Using a Graft from a Donor with Situs Inversus Totalis: A Case Report and Review of the Literature. Case Rep Transplant. 2013;2013:532865.
  • 2. Argüder E, Köksal A, Gümüş B, Celenk MK. A case with double vena cava superior discovered during the investigating of persistent cough. Tuberk Toraks. 2012;60:199-200.
  • 3. Arya SV, Das A, Singh S, Kalwaniya DS, Sharma A, Thukral BB. Technical difficulties and its remedies in laparoscopic cholecystectomy in situs inversus totalis: A rare case report. Int J Surg Case Rep. 2013;4:727-30.
  • 4. Vijayakumar V, Kandappan G, Udayakumar P, Padmanabhan R. What is normal in an abnormality? Central venous cannulation in a patient with Situs inversus totalis with dextrocardia and polyCystic kidney disease. Indian J Crit Care Med. 2013;17:262-3.
  • 5. Burney K, Young H, Barnard SA, McCoubrie P, Darby M. CT appearances of congential and acquired abnormalities of the superior vena cava. Clin Radiol. 2007;62:837-42.
  • 6. Albay S, Cankal F, Kocabiyik N, Yalcin B, Ozan H. Double superior vena cava. Morphologie. 2006;90:39-42.
  • 7. Demos TC, Posniak HV, Pierce KL, Olson MC, Muscato M. Venous anomalies of the thorax. Am J Roentgenol. 2004;182:1139-50.
  • 8. Günay E, Halıcı B, Okur N, Aldemir M, Ünlü M. The coexistence of persistant left superior vena cava with a left intrathoracic subclavian artery aneurysm. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2013;21:843-4.
  • 9. Cooper CJ, Gerges AS, Anekwe E, Hernandez GT. Double superior vena cava on fistulogram: A case report and discussion. Am J Case Rep. 2013;14:395-7.
  • 10. Demirkan B, Gungor O, Turkvatan A, Guray Y, Guray U. Images of persistent left superior vena cava draining directly into left atrium and secundum-type atrial septal defect. J Cardiovasc Comput Tomogr. 2010;4:70-2.
  • 11. Dogan E, Dogan MM, Gul S, Cullu N. Left persistent superior vena cava with large coronary sinus: A case report. J Surg Med. 2019;3(2):194-6.
  • 12. Ugaki S, Kasahara S, Fujii Y, Sano S. Anatomical repair of a persistent left superior vena cava into the left atrium. Interact Cardiovasc Thorac Surg. 2010;11:199-201.