CTICasesAnomalous Systemic Venous Connection
Imaging findings
Contrast-enhanced chest CT in a patient with recurrent pulmonary embolism demonstrates a meandering left lower lobe pulmonary vein draining into the left atrium. In addition, there is a persistent left superior vena cava (SVC) that drains anomalously directly into the left atrium instead of the coronary sinus, medial to the left pulmonary artery.
Key takeaways
Anomalous systemic venous connection, such as a persistent left SVC draining directly into the left atrium, is a rare congenital anomaly that creates a right-to-left shunt. It is often diagnosed incidentally during cardiac CTA or PE studies. The connection of the systemic vein to the left atrium can cause arterial desaturation or paradoxical emboli, and must be recognized prior to central line placement.
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