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Eur J Cardiothorac Surg 1999;14:326-328
© 1999 Elsevier Science NL

Case report

Aortic valve stenosis causing a left-to-right shunt in persistent left superior vena cava communicating with the left atrium

^a Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
^b Department of Medicine, Tampere University Hospital, Tampere, Finland

Received 12 January 1998; received in revised form 18 May 1998; accepted 26 May 1998.

Corresponding author. Fax: +358 3 2475756.

This study demonstrated a rare anomaly of a persistent left superior vena cava draining into the left atrium in a patient with developing left-to-right shunt caused by bicuspid aortic stenosis. The venous system, including the coronary sinus, was otherwise normal. We believe that, in this anatomic situation, a marked increase in left ventricular impedance caused a moderate left-to-right shunt from the left atrium into the left innominate vein. At operation, the aortic valve was replaced with a mechanical prosthesis and the anomalous vein was ligated. The convalescence was uneventful.

Key Words: Left superior vena cava • Left-to-right shunt • Aortic valvular stenosis