Double superior venae cavae with absence of the coronary sinus and anomalies of the azygos venous system

  • Eiji Notsu
  • Koji Ono
  • Sawa Horie
  • John F. Morris
  • Kazunori ToidaEmail author
Case Report


The superior vena cava is formed during the fetal period by the development of anastomoses between the right and left anterior cardinal veins, and the regression of the central part of the left anterior cardinal vein. The persistence of this part of the left anterior cardinal vein causes the formation of a left superior vena cava, which is a rare anomaly in cadaver dissection. We report the case of a persistent left superior vena cava with a normal right superior vena cava in a 95-year-old male cadaver, which was discovered during anatomical dissection for medical students at Kawasaki Medical School in 2016. The left superior vena cava was formed by the confluence of the left internal jugular and left subclavian veins and terminated in the right atrium via what would normally be the coronary sinus. The right and left superior venae cavae received intercostal veins via a right and left azygos vein, respectively. However, the right azygos vein was shorter than the normal azygos vein and received only the second to fifth intercostal veins, whereas the left azygos vein received the fifth to eleventh left intercostal veins and the sixth to eleventh right intercostal veins. We consider that the anomalies of the azygos venous system were the result of regression of right supracardinal vein and the persistence of the left supracardinal vein during development. An awareness of such variations of major thoracic veins is important for the interpretation of unusual CT images.


Azygos vein Coronary sinus Gross anatomy Intercostal vein Left superior vena cava 



We thank Mr. Kazuo Ikeda and Ms. Machiko Takabuchi of the Department
of Anatomy of Kawasaki Medical School for technical and secretarial assistances. We thank Kawasaki Medical School for their generous financial assistance. We thank Nia Cason, PhD, from Edanz Group ( for editing a draft of this manuscript.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflicts of interest.


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Copyright information

© Japanese Association of Anatomists 2020

Authors and Affiliations

  • Eiji Notsu
    • 1
  • Koji Ono
    • 1
  • Sawa Horie
    • 1
  • John F. Morris
    • 2
  • Kazunori Toida
    • 1
    • 3
    Email author
  1. 1.Department of AnatomyKawasaki Medical SchoolKurashikiJapan
  2. 2.Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
  3. 3.Research Center for Ultra-High Voltage Electron MicroscopyOsaka UniversityOsakaJapan

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