Antenatal diagnosis of isolated, single left superior vena cava and its
association with coarctation of the aorta: a retrospective review over a
15-year period
Abstract
To assess the association between single, isolated left SVC and
coarctation of the aorta. Retrospective review Fetal cardiac centre in
London, split across two sites. 24001 fetal cardiac scans performed
between April 2005 and March 2020, of which 24 fetuses were found to
have isolated single left SVC. Retrospective analysis of clinical
reports and outcome data were examined from routinely captured clinical
data; this data was compared to gestation-matched references. Presence
of aortic arch hypoplasia and/or coarctation of the aorta. 289 fetuses
were identified with left SVC, of those 24 (8.3%) had single left SVC
with agenesis of the right SVC. 95.8% (23/24) were identified after the
introduction of the 3VV to the fetal anomaly screening programme in 2010
of which 58.35 (14/24) were diagnoses after the addition of the 3VT in
2015. All fetuses were successfully delivered without any postnatal
complications. None were found to have aortic arch hypoplasia or
coarctation of the aorta. Single LSVC does not appear to be associated
with CoA and can be considered a benign congenital anomaly. Changes in
streaming of flow across the patent foramen ovale, thus maintaining
adequate perfusion of the aortic isthmus in fetal life, may be the
reasons for not developing coarctation of the aorta. Furthermore,
frequency of antenatal scans can be minimized, and postnatal management
adjusted accordingly as single LSVC in the absence of right SVC does not
appear to result in development of coarctation of the aorta, neither
antenatally nor after birth.