Methods
We searched the literature to identify the described instances of
retrotracheal/ retroaortic/anomalous/aberrant left brachiocephalic vein,
along with circumaortic double left brachiocephalic vein. We evaluated
all clinical as well as autopsy studies, seeking to establish accounts
of the anatomy, the prevalence of isomerism, problems in establishment
of diagnosis, and the variations in the associated cardiac and aortic
arch anomalies. We then assessed its influence on surgical techniques
used in treatment, and their outcomes. The search engines employed were
PubMed, Google Scholar, Cochrane Database for Systematic Reviews,
Cochrane Central Register of Controlled Trials, Ovid Medline, ACP
Journal Club, Ovid EMBASE, and Database of Abstracts of Review of
Effectiveness in all languages.
This strategy provided 80 investigations that provided the best answers
to these topics. We have then synthesized all available data,
establishing issues of concern, diagnostic clues, and various techniques
performed to repair the primary as well as concomitant anomalies, hoping
to improve future surgical management.
Due to limited sample sizes, heterogeneity of clinical state at the time
of surgical intervention, and difficulties in selection of appropriate
cardiac quantifiable end points, we were unable to achieve a
meta-analysis.