Persistent Left Superior Vena Cava—When a Left-Sided Central Line Does Not Make the Turn: A Case Report

2021 ◽  
pp. 108925322199855
Author(s):  
Michael S. Trostler ◽  
Raymond M. Planinsic
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Venous Blood ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Line ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Increased Risk ◽  
Venous Blood Gas

A 59-year-old male presenting for a living nonrelated kidney transplant has an intraoperative left internal jugular central venous catheter placed for operative access and monitoring. Post-anesthesia care unit postoperative chest X-ray shows possible aortic placement as read by radiology. The catheter is confirmed venous on insertion, with monitoring during the operation, and with repeat transduction and venous blood gas results postoperatively. A follow-up computed tomography scan shows findings consistent with persistent left superior vena cava. This can be associated with other cardiac abnormalities and an increased risk of complications, both mechanical and physiological. Care should be taken in patients identified with persistent left superior vena cava to prevent complications in future procedures.

Knowledge of the Anomalies of the Big Central Veins Reduces the Morbidity during the Cannulation for Hemodialysis: Description of a Case of Persistent Left Superior Vena Cava and Revision of Literature

2003 ◽  
Vol 4 (1) ◽  
pp. 25-31 ◽  
Author(s):  
P. Dionisio ◽  
C. Borsetti ◽  
M. Valenti ◽  
E. Caramello ◽  
R. Bergia ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Venous ◽  
Left Superior Vena Cava ◽  
Cardinal Vein ◽  
Persistent Left Superior Vena ◽  
Congenital Agenesis

The persistence of a left superior vena cava is the result of a lack of an embryological involution of the left anterior cardinal vein. This anomaly is very rare: about 0.3% of the general population. Its incidence increases remarkably from 3–10% in those patients affected with congenital heart disease. Described herein is a case of persistent left superior vena cava, discovered by chance, following the placement of a central venous catheter for hemodialysis. A chest X-ray in projection back-forward showed the central venous catheter along the left sternal margin simulating a placement in the aorta artery. This clinical picture, as described in the literature, is often accompanied by other anatomical anomalies, in our case, by the congenital agenesis of a solitary pelvic kidney. In agreement with the literature and in contrast with what has been reported recently, we sustain that a central venous catheter placed, for any reason, in the persistent left superior vena cava must be removed immediately because it can induce hyperkinetic arrhythmia and cardiac arrest as in our case. Our case report should be a warning that lack of awareness of the anomalies of the big central veins can cause a rise in morbidity.

Endocavitary Electrocardiography during Central Vein Catheter Positioning in a Newborn with Persistent Left Superior Vena Cava

2009 ◽  
Vol 10 (3) ◽  
pp. 212-213 ◽  
Author(s):  
Luigi Avolio ◽  
Antonio Rinaldi ◽  
Gianpaolo Serafini ◽  
Giuseppe Martucciello
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Term Infant ◽  
P Wave ◽  
Central Vein ◽  
Qrs Complex ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

We report an unusual presentation of the P wave and QRS complex during ECG-guided endocavitary assessment of the proper location of the central venous catheter in a pre-term infant operated on for esophageal atresia. The P wave and QRS complex had a normal morphology, but lay specularly to normal above the isoelectric line. The chest X-ray showed that the unusual ECG pattern was due to the left paracardiac position of the catheter, just lateral to the aortic arch within a persistent left superior vena cava.

scholarly journals Persistent Left Superior Vena Cava in Hematological Malignancy Requiring Central Venous Catheter Insertion for Intensive Chemotherapy

2015 ◽  
Vol 8 (3) ◽  
pp. 478-481 ◽  
Author(s):  
Osamu Imataki ◽  
Hiroyuki Kubo ◽  
Yukiko Hamasaki ◽  
Maki Oku ◽  
Jun-ichiro Kida ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Superior Vena Cava ◽  
Coronary Sinus ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Intensive Chemotherapy ◽  
Central Venous ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

Persistent left superior vena cava is a congenital vascular anomaly, which is possibly arrhythmogenic and thrombogenic, rarely complicated with coronary sinus atresia. We treated a 42-year-old male with Hodgkin's lymphoma requiring central venous catheter placement for intensive chemotherapy. Persistent left superior vena cava was revealed after the insertion of the central venous catheter by the radiological finding of the catheter tip cannulated into the vena cava cavity. The relationship between coronary sinus atresia and persistent left superior vena cava induced by central venous catheterization remains unclear; however, the hematologist should pay attention to the malpositioning of the central venous catheter.

scholarly journals Concomitant Persistent Left Superior Vena Cava and Horseshoe Kidney

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Faraz Jaffer ◽  
Vijay Chandiramani
Keyword(s):  
Superior Vena Cava ◽  
Hepatorenal Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Horseshoe Kidney ◽  
Venous Catheter ◽  
Drainage Pattern ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
X Ray

Persistent left superior vena cava (PLSVC) and horseshoe kidney (HSK) are common congenital abnormalities; however presence of both in the same person is extremely rare. A patient with hepatitis C cirrhosis awaiting transplant presented with worsening liver dysfunction, diagnosed with acute renal failure secondary to hepatorenal syndrome, and required X-ray fluoroscopy guided tunneled venous catheter placement for hemodialysis. Review of imaging studies demonstrated coexistence of PLSVC and HSK. PLSVC in adulthood is usually incidental with the most common drainage pattern being without physiologic dysfunction. Isolated horseshoe kidney is still the most common of renal fusion anomalies; however etiology of coexistent PLSVC remains unknown.

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