Left-Sided High-Flow Arteriovenous Hemodialysis Fistula Combined with a Persistent Left Superior Vena Cava Causing Coronary Sinus Dilatation


Address Correspondence to: Michael Wolf, M.D., Lindendreef 1, B-2020 Antwerp, Belgium, Tel.: + 32 3 280 32 55 or e-mail: michael.wolf@telenet.be.


We present an interesting case illustrating the possible hemodynamic consequences when a left-sided arteriovenous hemodialysis fistula is combined with the congenital anomaly of a persistent left superior vena cava (PLSVC). Our case illustrates the importance of an echocardiographic examination with attention to the coronary sinus (CS) caliber—raising suspicion of a PLSVC—in the assessment for the hemodialysis access in end-stage renal disease patients. The causes and symptoms of CS dilatation, as well as the literature on PLSVC, are also discussed in detail.