Double Superiorvenacava and Its Associated Clinical Implications - a Case Report and Literature Review

Abnormalities of the vascular system are always of extreme interest due to its importance in circulation. Normally the superior vena cava is a single vascular structure formed by the union of right and left brachiocephalic veins which are in turn formed by the union of corresponding internal jugular and subclavian veins, draining the head and neck as well as the superior extremity. However during routine dissection in the Department of Anatomy, Kasturba Medical College, Manipal, we came across a case of double superior vena cava with persistent left superior vena cava in a 58-year-old male cadaver. Both the vena cavae were formed as continuations of brachiocephalic veins of the corresponding side. The persistent left superior vena cava opened into the enlarged coronary sinus that drained into the right atrium between the opening of inferior venacava and right atrioventricular orifice. No communication was observed between the two vena cavae. A persistent left superior vena cava does not by itself produce any physiological derangement. But it has important clinical implications in certain clinical interventions. It may complicate placement of cardiac catheters or pacemaker leads. Awareness of this anomaly may therefore reduce confusions and thus would help to avoid further complications.