# Frequency of Persistent Left Superior Vena Cava and Its Impact on Outcomes in Children Undergoing Congenital Heart Surgery

## TL;DR

This study found that persistent left superior vena cava occurs in 6.5% of children with congenital heart disease and is linked to specific heart defects.

## Contribution

The study provides new insights into the frequency and clinical associations of persistent left superior vena cava in pediatric congenital heart surgery.

## Key findings

- PLSVC was detected in 6.5% of 4,000 children with congenital heart disease.
- PLSVC is commonly associated with heterotaxy syndrome and atrioventricular septal defect.
- Preoperative detection of PLSVC can improve surgical management and outcomes.

## Abstract

This study aimed to investigate the frequency of persistent left superior
vena cava (PLSVC) and its impact on outcomes in children undergoing
congenital heart surgery.

The study was conducted retrospectively in cases diagnosed with congenital
heart disease who were operated on under the age of 16 years between October
1st, 2021, and October 1st, 2024, at two major
tertiary centers. The frequency of PLSVC and its possible impact on surgical
outcomes were evaluated in these cases. The results were analyzed
statistically.

There were 4,000 cases during the study period, with 52% being male. The
median weight was 5.2 kg (interquartile range 4.5 - 6 kg). PLSVC was
detected in a total of 260 cases (6.5%). Of these cases, 92.3% (240/260)
drained into the coronary sinus, while 7.7% (20/260) drained directly into
the left atrium. In 251 (96.5%) of the patients with PLSVC, there was a
right SVC, while nine (3.5%) did not have a right SVC. Of the 251 patients
with double SVC, 105 (42%) had a normal innominate vein. PLSVC was primarily
associated with heterotaxy syndrome, atrioventricular septal defect, and
vascular ring defects.

There is an increased frequency of PLSVC among certain congenital heart
disease groups, and raising awareness during echocardiographic examination
can facilitate the diagnosis of PLSVC. Preoperative diagnosis of PLSVC can
help in managing complications more effectively