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

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.

2003 ◽  
Vol 4 (1) ◽  
pp. 25-31 ◽  
Author(s):  
P. Dionisio ◽  
C. Borsetti ◽  
M. Valenti ◽  
E. Caramello ◽  
R. Bergia ◽  
...  

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.


2015 ◽  
Vol 8 (3) ◽  
pp. 478-481 ◽  
Author(s):  
Osamu Imataki ◽  
Hiroyuki Kubo ◽  
Yukiko Hamasaki ◽  
Maki Oku ◽  
Jun-ichiro Kida ◽  
...  

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Faraz Jaffer ◽  
Vijay Chandiramani

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.


SpringerPlus ◽  
2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Jan M Sohns ◽  
Martin Fasshauer ◽  
Wieland Staab ◽  
Michael Steinmetz ◽  
Christina Unterberg-Buchwald ◽  
...  

2020 ◽  
Vol 24 (4) ◽  
pp. 374-377
Author(s):  
Faisal D. Arain ◽  
Jacqueline Sohn ◽  
Raymond G. Graber

Persistent left superior vena cava (PLSVC) is a rare abnormality with incidence reported as 0.3% to 0.5% in the general population and about 10 times higher in patients with congenital heart disease. The diagnosis of PLSVC in native or donor hearts of patients undergoing heart transplants has been reported in surgical journals. However, this rare finding has not been described in similar heart transplant settings in anesthesia literature. This case describes a 44-year-old male orthotopic heart transplant recipient who was incidentally diagnosed with PLSVC in his native heart on transesophageal echocardiogram after a central venous catheter placement. The particular position of the central venous catheter, in our case, raised the suspicion of PLSVC but needed further verification. With the help of images and videos, we demonstrate that transesophageal echocardiogram can be instrumental in diagnosing PLSVC. Furthermore, the case highlights the importance of effectively communicating with the surgeon about such a finding so that the surgical plan can be modified in a timely manner.


2017 ◽  
Vol 83 (3) ◽  
pp. 76-77
Author(s):  
Scott G. Blair ◽  
Celia Y. Quang ◽  
Kelsey C. R. Mckee ◽  
Jon D. Simmons ◽  
Sidney B. Brevard

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