Persistent Left Superior Vena Cava Draining Directly into Left Atrium and Normal Coronary Sinus

A persistent left superior vena cava is a frequent variation of the thoracic venous system and is explained by the persistence of the left superior cardinal vein. However, in most cases, it drains into the coronary sinus. It sometimes terminates directly into the left atrium but this anomaly is usually associated with the absence of the coronary sinus. To our knowledge, only rare cases of a persistent left superior vena cava terminating into the left atrium with a normal coronary sinus have been described. In this article, we present a case with a direct connection between the left superior vena cava and the left atrium, diagnosed by saline contrast echocardiography, and describe the contribution of echocardiography in the diagnosis of a persistent left superior vena cava. Echocardiography is a reliable and easy diagnostic tool that allows a bedside approach in a patient in whom there is suspicion of a persistent left superior vena cava, without the administration of radiographic contrast