View source for Paper - Persistent left superior vena cava, left duct of cuvier and left horn of the sinus venosus


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{{Ref-Basu1932}}
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| [[File:Mark_Hill.jpg|90px|left]] This historic 1932 paper by Basu describes an embryological abnormality identified in an adult.

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=Persistent “Left Superior Vena Cava”, “Left Duct of Cuvier” and “Left Horn of the Sinus Venosus”=

By Bhupendra Nath Basu, M.B. Assistant Professor of Anatomy, Carmichael Medical College, Calcutta.


The presence of two superior venae cavae is of rare occurrence in adult life. During my experience of the last 14 years in the Anatomical Department of the Carmichael Medical College, Calcutta, while more than 600 bodies have been dissected, I have not come across a condition similar to that noted in this case ; "although one gathers from the literature that it is not an uncommon abnormal condition.


The specimen under review was dissected out from a subject brought to this department from the hospital. The records of the case showed that the subject was a Hindu male, aged 42 years. His body was thinly built and he was a day labourer by occupation. He died of pneumonia, and during dissection of his body the following abnormal conditions of the cardio-vascular systems were found:

# The heart and the great veins very much dilated and ﬁlled up with blood clot.
# The presence of two superior venae cavae opening separately into the right atrium of the heart.
# Absence of the transverse portion of the left innominate vein.
# Absence of the coronary sinus.
# The union of the left superior vena cava with the inferior vena cava before opening into the lower part of the right atrium of the heart by means of a common opening.


The right innominate vein is formed by the union of the right jugular and the right subclavian veins. It leads downwards and continues as the right superior vena cava which opens at the upper and back part of the right atrium of the heart. The left innominate vein begins by the junction of the left jugular and the left subclavian veins and passes vertically downwards into the left side of the superior mediastinum, crossing in its course the arch of the aorta and the structures forming the root of the left lung. It is continued as the left superior vena cava behind the left auricula and on the dorsal aspect of the heart, occupying the coronary sulcus. While situated on the dorsal side of the heart it receives all the tributaries of the adult coronary sinus (cardiac veins). Finally, it unites with the inferior vena cava just before they pass into the lower and back part of the right atrium of the heart through a common opening. The left superior intercostal vein joins with the left superior vena cava before the latter passes into the back of the heart.


==Embryological explanation==

This is a case of rare developmental anomaly in which the left anterior cardinal vein and the left duct of Cuvier, of foetal life, are remaining patent throughout their whole course and are persisting as a single vein which is characterised as the left superior vena cava. The right superior vena cava is present in this case, but the transverse anastomosis which usually forms the left innominate vein is entirely absent.

This condition is normal in some Mammals, but it is very rare in Man.

[[File:Basu1932 fig01.jpg|600px]]

The two drawings—one of the anterior and the other of the posterior view of the heart and the great blood vessels—illustrate the abnormalities of the specimen.


The peculiarity of this particular specimen is that the left superior vena cava is joined with the inferior vena cava to form a common trunk before they pass into the lower and back part of the right atrium of the heart through a common opening. The only possible explanation of this condition is that not only the left horn of the sinus venosus but a part of the right horn also persists. This portion of the right horn is usually incorporated within the cavity of the right atrium, into which the inferior vena cava opens.


In conclusion I wish to express my warm thanks to my chief, Prof. M. N. Bose, M.B., C.M. (Edin.), for kindly giving me every facility to review the specimen.

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[[Category:Cardiovascular]][[Category:Abnormal Development]][[Category:1930's]]