Case of persistent left superior vena cava draining via the left atrium with a normal coronary sinus utilizing cardiac CT

With an estimated incidence of ∼0.5%-2% of the population and 10% of patients with congenital heart disorders, persistent LSVC is the most common venous anomaly of the chest. Most drain via the right atrium. Rarely (7.5% of cases), the persistent LSVC may drain directly into the left atrium. These are typically seen with a coronary sinus type atrial septal defect with many investigators believing that, embryologically, a normal coronary sinus cannot exist in the setting of a persistent LSVC draining into the left atrium. There have been few case reports of this in the setting of a normal coronary sinus. With the assistance of cardiac CT, we were able to show the existence of this rare entity. The CT images provided guidance for a successful endovascular repair.