J o u r n a l o f C a r d i o v a s c u l a r C o m p u t e d T o m o g r a p h y 9 ( 2 0 1 5 ) 2 3 6 e2 3 7
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.JournalofCardiovascularCT.com
Images in Cardiovascular CT
Anomalous small cardiac vein draining into the superior vena cava Selc¸uk Akkaya MD, Selin Ardalı MD, Sinan Balcı MD, Tuncay Hazirolan MD* Department of Radiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey
article info
abstract
Article history:
Coronary venous anatomy is little studied, and an abnormal coronary vein drainage is a
Received 15 January 2015
rarely reported entity. Few cases about abnormal drainage of the great cardiac vein into the
Received in revised form
superior vena cava have been reported in literature. Herein we present a case of anomalous
21 January 2015
small cardiac vein draining into superior vena cava.
Accepted 26 January 2015
ª 2015 Society of Cardiovascular Computed Tomography. All rights reserved.
Available online 2 February 2015 Keywords: Small cardiac vein Superior vena cava Anomalous drainage
A 75-year-old female patient with a history of aortic and mitral valve replacement was admitted to our hospital for the evaluation of the presence of paravalvular aortic regurgitation. Retrospectively electrocardiography-gated coronary CT angiography was performed with a first-generation dualsource CT system. Tube voltage was 120 kVp, tube current 320 mAs per rotation, and gantry rotation time 0.33 seconds. Eighty milliliters of nonionic contrast agent at a flow rate of 5 mL/second was administered intravenously, followed by a 50-mL saline flush at 5 mL/second. Coronary CT angiography demonstrated normal coronary arteries. As an incidental finding, a small cardiac vein draining into superior vena cava was found (Figs. 1, 2). The remaining venous anatomy was
normal with the great cardiac vein, middle cardiac vein, and posterior cardiac vein draining into the coronary sinus and right atrium (Fig. 3). Coronary venous anatomy is rarely studied, and abnormal coronary vein drainage is infrequently reported in the literature. A small number of case reports describe abnormal drainage of the great cardiac vein into the superior vena cava.1e3 However, to our knowledge, no case of an anomalous small cardiac vein draining into superior vena cava has been reported. Coronary venous anomalies are usually asymptomatic. Knowledge of cardiac anomalous venous drainage may bear importance for biventricular lead placement and for retrograde cardioplegia during cardiovascular surgery.
Conflict of interest: The authors report no conflicts of interest. * Corresponding author. E-mail address: [email protected] (T. Hazirolan). 1934-5925/$ e see front matter ª 2015 Society of Cardiovascular Computed Tomography. All rights reserved. http://dx.doi.org/10.1016/j.jcct.2015.01.013
J o u r n a l o f C a r d i o v a s c u l a r C o m p u t e d T o m o g r a p h y 9 ( 2 0 1 5 ) 2 3 6 e2 3 7
237
Fig. 1 e Axial coronary CT angiography shows small cardiac vein draining into superior vena cava. SCV, small cardiac vein; SVC, superior vena cava.
Fig. 3 e Volume-rendered image of coronary CT. Great cardiac vein runs in anterior atrioventricular groove and then drains into coronary sinus. CS, coronary sinus; GCV, great cardiac vein; LA, left atrium; RA, right atrium.
references
lu AK, Oztu¨rk E. Case images: 1. Incedayı M, Is‚ılak Z, Sivriog abnormal draining of the great cardiac vein into the superior vena cava. Turk Kardiyol Dern Ars. 2013;41:87. 2. Loukas M, Bilinsky S, Bilinsky E, el-Sedfy A, Anderson RH. Cardiac veins: a review of the literature. Clin Anat. 2009;22:129e145. 3. Lee HM, Sung YM, Lee JI. Anomalous great cardiac vein draining into the superior vena cava. Ann Thorac Surg. 2011;92:360.
Fig. 2 e Volume-rendered image of coronary CT angiography shows small cardiac vein draining into superior vena cava. RA, right atrium; RCA, right coronary artery; SCV, small cardiac vein; SVC, superior vena cava.
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.JournalofCardiovascularCT.com
Images in Cardiovascular CT
Anomalous small cardiac vein draining into the superior vena cava Selc¸uk Akkaya MD, Selin Ardalı MD, Sinan Balcı MD, Tuncay Hazirolan MD* Department of Radiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey
article info
abstract
Article history:
Coronary venous anatomy is little studied, and an abnormal coronary vein drainage is a
Received 15 January 2015
rarely reported entity. Few cases about abnormal drainage of the great cardiac vein into the
Received in revised form
superior vena cava have been reported in literature. Herein we present a case of anomalous
21 January 2015
small cardiac vein draining into superior vena cava.
Accepted 26 January 2015
ª 2015 Society of Cardiovascular Computed Tomography. All rights reserved.
Available online 2 February 2015 Keywords: Small cardiac vein Superior vena cava Anomalous drainage
A 75-year-old female patient with a history of aortic and mitral valve replacement was admitted to our hospital for the evaluation of the presence of paravalvular aortic regurgitation. Retrospectively electrocardiography-gated coronary CT angiography was performed with a first-generation dualsource CT system. Tube voltage was 120 kVp, tube current 320 mAs per rotation, and gantry rotation time 0.33 seconds. Eighty milliliters of nonionic contrast agent at a flow rate of 5 mL/second was administered intravenously, followed by a 50-mL saline flush at 5 mL/second. Coronary CT angiography demonstrated normal coronary arteries. As an incidental finding, a small cardiac vein draining into superior vena cava was found (Figs. 1, 2). The remaining venous anatomy was
normal with the great cardiac vein, middle cardiac vein, and posterior cardiac vein draining into the coronary sinus and right atrium (Fig. 3). Coronary venous anatomy is rarely studied, and abnormal coronary vein drainage is infrequently reported in the literature. A small number of case reports describe abnormal drainage of the great cardiac vein into the superior vena cava.1e3 However, to our knowledge, no case of an anomalous small cardiac vein draining into superior vena cava has been reported. Coronary venous anomalies are usually asymptomatic. Knowledge of cardiac anomalous venous drainage may bear importance for biventricular lead placement and for retrograde cardioplegia during cardiovascular surgery.
Conflict of interest: The authors report no conflicts of interest. * Corresponding author. E-mail address: [email protected] (T. Hazirolan). 1934-5925/$ e see front matter ª 2015 Society of Cardiovascular Computed Tomography. All rights reserved. http://dx.doi.org/10.1016/j.jcct.2015.01.013
J o u r n a l o f C a r d i o v a s c u l a r C o m p u t e d T o m o g r a p h y 9 ( 2 0 1 5 ) 2 3 6 e2 3 7
237
Fig. 1 e Axial coronary CT angiography shows small cardiac vein draining into superior vena cava. SCV, small cardiac vein; SVC, superior vena cava.
Fig. 3 e Volume-rendered image of coronary CT. Great cardiac vein runs in anterior atrioventricular groove and then drains into coronary sinus. CS, coronary sinus; GCV, great cardiac vein; LA, left atrium; RA, right atrium.
references
lu AK, Oztu¨rk E. Case images: 1. Incedayı M, Is‚ılak Z, Sivriog abnormal draining of the great cardiac vein into the superior vena cava. Turk Kardiyol Dern Ars. 2013;41:87. 2. Loukas M, Bilinsky S, Bilinsky E, el-Sedfy A, Anderson RH. Cardiac veins: a review of the literature. Clin Anat. 2009;22:129e145. 3. Lee HM, Sung YM, Lee JI. Anomalous great cardiac vein draining into the superior vena cava. Ann Thorac Surg. 2011;92:360.
Fig. 2 e Volume-rendered image of coronary CT angiography shows small cardiac vein draining into superior vena cava. RA, right atrium; RCA, right coronary artery; SCV, small cardiac vein; SVC, superior vena cava.
