{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:45:41Z","timestamp":1788587141260,"version":"build-2803163510"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly and is often associated with complex congenital heart disease (CHD). Venous drainage typically occurs into the right atrium via the coronary sinus (CS). However, in 10\u201320% of cases, it drains into the left atrium, producing a right-to-left shunt that may result in symptoms and cerebrovascular complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A 23-year-old woman with a history of double-outlet right ventricle corrected at age 13 presented in the postpartum period with dysarthria, left central facial palsy and left hemiparesis. Brain MRI angiography revealed right middle cerebral artery (M2) occlusion, and she underwent thrombolysis and thrombectomy. Suspecting a cardioembolic event, transesophageal echocardiography with left-arm agitated saline injection revealed early left atrial opacification and delayed right-sided filling via a residual ventricular septal defect \u2014suggesting a PLSVC draining into the left atrium. Cardiac CT confirmed CS agenesis and a PLSVC connected to the left atrial roof. She was discharged on enoxaparin.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>PLSVC is a vascular anomaly with an estimated prevalence of 0.2-3% in the general population and 1-12% among CHD patients. A dilated CS on transthoracic echocardiography should prompt a bubble test; early opacification of the left chambers after left-arm saline injection suggests drainage to the left atrium. Cardiac CT, MRI or invasive angiography can clarify the anatomy.<\/jats:p>\n            <jats:p>PLSVC has clinical implications including technical considerations for percutaneous procedures and cardiac surgery, a predisposition for arrhythmias, and \u2014when draining into the left atrium\u2014 an increased risk of cerebrovascular events. Closure of a PLSVC draining into the left atrium should be considered in symptomatic patients or those at high risk of paradoxical embolism, following anatomical assessment.<\/jats:p>\n            <jats:p>In pregnant women with CHD, cardiac risk assessment, multimodal imaging and multidisciplinary follow-up are crucial due to associated hemodynamic changes and hypercoagulable state.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12872-025-04922-2","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T02:50:57Z","timestamp":1751597457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Postpartum ischemic stroke due to persistent left superior vena cava to left atrium after DORV repair: a case report and literature review"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0601-8506","authenticated-orcid":false,"given":"Paula Andrea","family":"C\u00e1rdenas-Mar\u00edn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-821X","authenticated-orcid":false,"given":"Jorge Alexander","family":"Zambrano-Franco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7835-9031","authenticated-orcid":false,"given":"Maria Juliana","family":"Reyes-Cardona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0677-6948","authenticated-orcid":false,"given":"Camilo Andres","family":"Calderon-Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5700-9255","authenticated-orcid":false,"given":"Jairo","family":"Sanchez-Blanco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4568-160X","authenticated-orcid":false,"given":"Pastor","family":"Olaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5423-4847","authenticated-orcid":false,"given":"Carlos Enrique","family":"Vesga-Reyes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"issue":"1","key":"4922_CR1","doi-asserted-by":"publisher","first-page":"18","DOI":"10.4274\/balkanmedj.2017.0910","volume":"35","author":"FO Mutluer","year":"2018","unstructured":"Mutluer FO, \u00c7eliker A. General concepts in adult congenital heart disease. Balkan Med J. 2018;35(1):18\u201329.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/29400306\/. Cited 2025 Feb 26.","journal-title":"Balkan Med J."},{"key":"4922_CR2","doi-asserted-by":"crossref","unstructured":"Daruwalla VJ, Parekh K, Tahir H, Collins JD, Carr J. Raghib syndrome presenting as a cryptogenic stroke: role of cardiac MRI in accurate diagnosis. Case Rep Cardiol. 2015;2015:1\u20135. Available from: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC4461698\/. Cited 2024 Sep 22.","DOI":"10.1155\/2015\/921247"},{"issue":"5","key":"4922_CR3","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1111\/echo.12514","volume":"31","author":"AS Sheikh","year":"2014","unstructured":"Sheikh AS, Mazhar S. Persistent left superior vena cava with absent right superior vena cava: review of the literature and clinical implications. Echocardiography. 2014;31(5):674\u20139. Available from: https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/echo.12514.","journal-title":"Echocardiography."},{"issue":"34","key":"4922_CR4","doi-asserted-by":"publisher","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","volume":"39","author":"V Regitz-Zagrosek","year":"2018","unstructured":"Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomstr\u00f6m-Lundqvist C, C\u00edfkov\u00e1 R, De Bonis M, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy: The Task Force for the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(34):3165\u2013241. Available from:https:\/\/doi.org\/10.1093\/eurheartj\/ehy340. 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Echocardiography. 2017;34(3):436\u201340.\u00a0Available from: https:\/\/pubmed.ncbi.nlm.nih.gov\/28052532\/.\u00a0Cited 2024 Sep 22.","journal-title":"Echocardiography."},{"key":"4922_CR7","doi-asserted-by":"crossref","unstructured":"Azizova A, Onder O, Arslan S, Ardali S, Hazirolan T. Persistent left superior vena cava: clinical importance and differential diagnoses. Insights Imaging. 2020;11(1). Available from: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7561662\/. Cited 2024 Sep 23.","DOI":"10.1186\/s13244-020-00906-2"},{"issue":"3","key":"4922_CR8","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.5830\/CVJA-2016-084","volume":"28","author":"KW Tyrak","year":"2017","unstructured":"Tyrak KW, Ho\u0142da J, Ho\u0142da MK, Koziej M, Piatek K, Klimek-Piotrowska W. Persistent left superior vena cava. Cardiovasc J Afr. 2017;28(3):e1.\u00a0Available from: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5558145\/.\u00a0Cited 2025 Feb 26.","journal-title":"Cardiovasc J Afr."},{"issue":"12","key":"4922_CR9","doi-asserted-by":"publisher","first-page":"1824","DOI":"10.1093\/europace\/euz254","volume":"21","author":"YG Kim","year":"2019","unstructured":"Kim YG, Han S, Choi J Il, Lee KN, Baek YS, Uhm JS, et al. Impact of persistent left superior vena cava on radiofrequency catheter ablation in patients with atrial fibrillation. EP Europace. 2019;21(12):1824\u201332.\u00a0Available from: https:\/\/doi.org\/10.1093\/europace\/euz254.\u00a0Cited 2025 Feb 19.","journal-title":"EP Europace."},{"issue":"3","key":"4922_CR10","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s11547-019-01114-9","volume":"125","author":"NM Batouty","year":"2020","unstructured":"Batouty NM, Sobh DM, Gadelhak B, Sobh HM, Mahmoud W, Tawfik AM. Left superior vena cava: cross-sectional imaging overview. Radiologia Medica. 2020;125(3):237\u201346.\u00a0Available from: https:\/\/link.springer.com\/article\/10.1007\/s11547-019-01114-9.\u00a0Cited 2025 Feb 25.","journal-title":"Radiologia Medica."},{"issue":"2","key":"4922_CR11","first-page":"1","volume":"32","author":"MA Al-Muhaya","year":"2020","unstructured":"Al-Muhaya MA, Alnajjar AA, Jelly AE, Syed AE, Morsy MMF, Al-Mutairi MB, et al. Anomalous drainage of persistent left superior Vena Cava to the left atrium: case series and literature review. J Saudi Heart Assoc. 2020;32(2):1\u20135.","journal-title":"J Saudi Heart Assoc"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-04922-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-025-04922-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-04922-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T02:50:58Z","timestamp":1751597458000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-025-04922-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,4]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4922"],"URL":"https:\/\/doi.org\/10.1186\/s12872-025-04922-2","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,4]]},"assertion":[{"value":"8 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This case report was reviewed and approved by the Institutional Review Board (IRB) of Fundaci\u00f3n Valle del Lili, Cali, Colombia. The patient provided informed consent for the use and publication of their medical information, and all identifying details have been anonymized to ensure confidentiality.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"463"}}