Journal of Cardiovascular Echography

: 2013  |  Volume : 23  |  Issue : 2  |  Page : 72-

Cardiac ultrasound and persistent left superior vena cava

Daniele Pontillo1, Nicolino Patruno2, Stefano Petronzelli2,  
1 Cardiology Division, Belcolle Hospital, Montefiascone Facility, Montefiascone (VT), Italy
2 Cardiology Division, S.Giuseppe Hospital, Albano Laziale (RM), Italy

Correspondence Address:
Daniele Pontillo
Via Stefanoni, 56 , 01027 Montefiascone (VT)

How to cite this article:
Pontillo D, Patruno N, Petronzelli S. Cardiac ultrasound and persistent left superior vena cava.J Cardiovasc Echography 2013;23:72-72

How to cite this URL:
Pontillo D, Patruno N, Petronzelli S. Cardiac ultrasound and persistent left superior vena cava. J Cardiovasc Echography [serial online] 2013 [cited 2020 Aug 13 ];23:72-72
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Full Text

Dear Sir,

We read with great interest the case report from Gibelli and Biasi [1] who define persistent left superior vena cava (PSLVC) not only as an anatomical variant. Actually, we agree with the authors especially in consideration of the huge number of cardiac invasive procedures in everyday clinical practice.

However, we would like to stress the concept, as we previously did, [2] that the complete workup should start beginning with a cardiac ultrasound examination enhanced with agitated saline contrast. The authors do mention this technique in the paper, but there is no trace of such examination in the case report. Even though the sensitivity and ultimately the reliability of cardiac magnetic resonance imaging (MRI) may be of paramount importance in the diagnosis of PLSVC, cardiac ultrasound is obviously easy, widely available, cost-effective, and highly sustainable in the very dark scenario grinding on the Italian health system. Additionally, we favor transesophageal echocardiography in our stepwise approach before heading to cardiac MRI to avoid Gadolinium-contrast exposure.

In conclusion, we support the authors' firm statement that the absence of the right superior vena cava should be looked after when PLSVC is identified; on the contrary, we prefer to follow a noninvasive workup protocol which consistently shares comparable diagnostic features of MRI when examining the venae cavae.


1Gibelli G, Biasi S. Persistent left superior vena cava and absent right superior vena cava: Not only an anatomic variant. J Cardiovasc Echogr 2013;23:42.
2Petronzelli S, Patruno N, Pontillo D. Persistent left superior vena cava: Diagnosis with saline contrast echocardiography. Heart 2008;94:835.