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.