The vein then joins the SVC near the insertion of the azygos vein. Individual measurements of left brachiocephalic vein (LBCV) diameter in normal fetuses and derived reference range for gestational age, showing median, 5th and 95th percentiles. Subclavian vein catheterization can result in arteriovenous fistula formation—a rare complication that will eventually lead to heart failure if left untreated. There was no significant change with gestational age in the intraobserver agreement of LBCV diameter measurement (r = 0.09, P = 0.43). All measurements were achieved in the absence of fetal breathing, since fetal breathing may alter venous return. In our case series, 68 fetuses were diagnosed with a persistent left SVC. As the subclavian artery crosses the lateral border of the first rib, it becomes the axillary artery. Thus, the SVC represents the major drainage system of venous blood from the head, neck, arms, and upper thorax. In 68 fetuses with a persistent left SVC, the LBCV was absent. Intrathymic course was not associated with any cardiac or extracardiac anomalies. Fetal LBCV was assessed prospectively during ultrasound examinations in 431 normal singleton pregnancies. In the prospective group, visualization and measurement of the fetal LBCV using 2D ultrasound was successful in most cases in the mid‐second and third trimesters of pregnancy (Table ). The SVC is formed by the junction of the brachiocephalic veins, which in turn are formed by the union of the internal jugular and subclavian veins. Intrathymic and other anomalous courses of the left brachiocephalic vein in the fetus. A dilated LBCV was found in association with increased perfusion, as observed in association with intracranial arteriovenous malformations. Kevin Rice, MD serves as the Medical Director of the Radiology Department of. A uniform protocol for the visualization and measurement of the fetal LBCV was used in all centers. Right subclavian vein and superior vena cava are now wide open. The region of the upper mediastinum in the fetus has drawn increasing interest since the three vessels and trachea view became part of the comprehensive fetal cardiac examination.

These normative data may provide an additional means to help in the detection of anomalies of systemic and pulmonary veins during pregnancy. The Kruskal–Wallis test was used to determine the significance of differences in the delta values of the LBCV diameter in the abnormal cases and normal controls. Recently with improvements in ultrasound technology, a few series and case presentations have reported on the accurate detection of anomalies of pulmonary venous connections in the fetus, either in isolation or as part of heterotaxy syndrome9-11. The supracardiac type is the most common and accounts for about 45% of all cases of TAPVC5. However this diagnosis is difficult to make in the fetus and most cases have been missed prenatally. All ultrasound examinations were performed using Voluson 730 Expert and Voluson E8 ultrasound equipment (GE Healthcare, Kretz Ultrasound, Zipf, Austria) with transabdominal high‐resolution 4–8‐MHz and RM‐6C transducers and a 5–9‐MHz transvaginal transducer. In normal fetuses LBCV diameter increased significantly throughout pregnancy, with a mean value of 0.7 mm at 11 weeks and 4.9 mm at term. The patient's arm swelling resolved within a few hours of the venoplasty. A dialysis fistula is a surgically created connection between an artery and vein, usually in the upper extremity. The use of color Doppler in addition to 2D ultrasound significantly improved the identification of the vessels at the level of the fetal upper mediastinum and was associated with the highest visualization rate of the fetal LBCV within each gestational age range.
Detailed analysis of fetal LBCV in the retrospective group of abnormal anatomy highlighted three types of congenital LBCV abnormality: abnormal size of the LBCV secondary to increased venous return across this vessel; abnormal course of the LBCV; and absence of the LBCV. In order to evaluate interobserver reproducibility of the LBCV measurements, 50 cases were randomly retrieved and the LBCV diameter was measured by two investigators (S.H.

Interobserver reproducibility was evaluated by calculating limits of agreement using Bland–Altman analysis and coefficient of variation (CV) in %, for which the following formula was used: Fetal LBCV diameter was successfully measured in 13/39 (33.3%) fetuses prior to 15 + 0 weeks' gestation and in 361/392 (92.1%) after 15 + 0 weeks. Our study has demonstrated that fetuses with supracardiac‐type TAPVC were found to have increased venous return across the LBVC, which resulted in significant dilation of this vessel.

Post venoplasty.
Number of times cited according to CrossRef: Fetal Left Brachiocephalic Vein (LBCV): Visualization and Its Measurements in Indian Population.