scholarly journals Peripherally inserted central catheter placement in neonates with persistent left superior vena cava: Report of eight cases

2021 ◽  
Vol 9 (26) ◽  
pp. 7944-7953
Author(s):  
Qiong Chen ◽  
Yan-Ling Hu ◽  
Ying-Xin Li ◽  
Xi Huang
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Catheter Placement ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

Persistent Left Superior Vena Cava

2014 ◽  
Vol 19 (2) ◽  
pp. 84-85 ◽  
Author(s):  
Vicki L. Mabry ◽  
Anne T. Mancino ◽  
Sheila Cox Sullivan
Keyword(s):  
Superior Vena Cava ◽  
Chest Radiograph ◽  
Incidental Finding ◽  
Superior Vena ◽  
Vena Cava ◽  
Vascular Anomaly ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

Abstract This is a case report of an incidental diagnosis of persistent left superior vena cava (PLSVC). The diagnosis was suspected after a peripherally inserted central catheter (PICC) was placed and a postinsertion chest radiograph was conducted. PLSVC is a vascular anomaly that is usually diagnosed as an incidental finding. Here, we discuss the tests performed to confirm the diagnosis and the 3 variants of PLSVC. Nurses who place PICCs are likely to run across this abnormality on postinsertion chest radiograph and knowing the diagnostic test to order to confirm the diagnosis is key in expediting patient care.

scholarly journals Persistent Left Superior Vena Cava Identified during Peripherally Inserted Central Catheter Line Placement

2019 ◽  
Vol 5 (02) ◽  
pp. 64-66
Author(s):  
Arvind Borde ◽  
Vivek Ukirde
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Anatomical Variant ◽  
Persistent Left Superior Vena ◽  
Line Placement ◽  
Picc Line

Abstract Introduction A persistent left superior vena cava (SVC) is found in 0.3 to 0.5% of the general population. It is seen in up to 10% of the patients with a congenital cardiac anomaly, being the most common thoracic venous anomaly, and is usually asymptomatic. Being familiar with such anomaly could help clinicians avoid complications during the placement of central lines, Swan-Ganz catheters, peripherally inserted central catheter (PICC) lines, dialysis catheters, defibrillators, and pacemakers. Case Presentation We describe a case of persistent left SVC which was noted after placement of a PICC line. A 5-year-old male child was hospitalized for evaluation and management of leukemia. He required PICC line placement for chemotherapy. He was noted to have a persistent left SVC during the procedure under fluoroscopic guidance and subsequently correct placement of PICC line in right SVC. Discussion This anatomical variant can pose iatrogenic risks if the clinician does not recognize it. A central catheter that tracks down the left mediastinal border may also be in the descending aorta, internal thoracic vein, superior intercostal vein, pericardiophrenic vein, pleura, pericardium, or mediastinum. Conclusion Our case is significant because the patient was diagnosed with double SVC on table only followed by the placement of PICC line into the right SVC. This case strongly demonstrates the importance of knowing the thoracic venous anomalies.

Paradoxical Electrocardiographic Rhythm During Peripherally Inserted Central Catheter Insertion from Persistent Left Superior Vena Cava

2017 ◽  
Vol 22 (1) ◽  
pp. 15-18
Author(s):  
Nicholas Mifflin ◽  
Vanno Sou ◽  
Evan Alexandrou ◽  
Antony Stewart ◽  
Jules Catt
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Gas Analysis ◽  
Arterial System ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Left Vena

Abstract Introduction: A persistent left superior vena cava is one of the most common thoracic vascular anomalies, present in approximately 0.5% of the general population. The most common presentation is both a right and left superior vena cava, communicating through an innominate vein. In rare cases, complete absence of a right sided superior vena cava may have dispersion of pacemaker and conduction tissue leading to abnormal electrocardiography readings. Case Description: This case report describes the insertion of a peripherally inserted central catheter via the right basilic vein utilising ultrasound and electrocardiographic guidance during which atypical P-waves were noted. Post procedure chest x-ray found the catheter to be positioned to the left side of the chest. Discussion and Evaluation: Initial management was to assess whether the catheter was placed in the arterial system. Catheter transduction and blood gas analysis demonstrated the peripherally inserted central catheter was situated in the venous system. Computer tomography was then used to assess the patient's vasculature, demonstrating a persistent left vena cava with absence of a right vena cava. Conclusion: This case describes the successful placement of a right basilic peripherally inserted central catheter in a patient with a persistent left vena cava with an absent right superior vena cave using ultrasound and electrocardiographic guidance.

Peripherally inserted central catheter malposition to a persistent left superior vena cava: A successful case to leave the catheter till the end of chemotherapy

2020 ◽  
pp. 112972982093820
Author(s):  
Qi Li ◽  
Yuxiu Liu ◽  
Min Wang ◽  
Zhongjie Yu ◽  
Yufang Gao
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Catheter Insertion ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Catheter Tip ◽  
Tip Position

Persistent left superior vena cava is rare and asymptomatic and is usually discovered incidentally during or after insertion of a central venous catheter. There is uncertainty as to whether or not the catheter should be removed after its malposition resulting in persistent left superior vena cava. We reported an unusual case of a breast cancer patient with a persistent left superior vena cava detected after a peripherally inserted central catheter insertion. The patient had undergone a modified radical mastectomy and needed to insert a peripherally inserted central catheter for chemotherapy. After the peripherally inserted central catheter insertion, the chest X-ray and computed tomography showed that the catheter was located in the persistent left superior vena cava. After an assessment of the persistent left superior vena cava and the catheter tip position, the peripherally inserted central catheter remained in the persistent left superior vena cava for further therapy. To ensure the integrity of the catheter, special follow-ups and tip position observations were carried out. The peripherally inserted central catheter was safe until the end of chemotherapy with no complications. Although the peripherally inserted central catheter tip was located in persistent left superior vena cava, given that the persistent left superior vena cava coexisted with a right superior vena cava with the similar lumen, the peripherally inserted central catheter could be used normally under strict attention.

Modified Insertion of a Peripherally Inserted Central Catheter: Taking the Chest Radiograph Earlier

2011 ◽  
Vol 31 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Geng Tian ◽  
Bin Chen ◽  
Li Qi ◽  
Yan Zhu
Keyword(s):  
Infection Rate ◽  
Superior Vena Cava ◽  
Chest Radiograph ◽  
Superior Vena ◽  
Vena Cava ◽  
Catheter Placement ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Tip

Placement of the tip of a peripherally inserted central catheter in the lower third of the superior vena cava is essential to minimize the risk of complications. Sometimes, however, the catheter tip cannot be localized clearly on the chest radiograph, and repositioning a catheter at bedside is difficult, sometimes impossible. A chest radiograph obtained just after the catheter is inserted, before the guidewire is removed, can be helpful. With the guidewire in the catheter, the catheter and its tip can be seen clearly on the radiograph. If the catheter was inserted via the wrong route or the tip is not at the appropriate location, the catheter can be repositioned easily with the guidewire in it. Between January 1, 2007, and May 31, 2009, 225 catheters were placed by using this method in our department. Of these, 33 tips (14.7%) were initially malpositioned. The tips of all these catheters were repositioned in the lower third of the superior vena cava by using this method. No catheter was exchanged or removed. The infection rate for catheter placement did not increase when this method was used. This modification facilitates accurate location of the catheter tip on the chest radiograph, making it easy to correct any malposition (by withdrawing, advancing, or even reinserting the catheter after withdrawal).

Application of Electrocardiogram Localization during Peripherally Inserted Central Catheter Line Insertion into the Persistent Left Superior Vena Cava of Neonates

2021 ◽  
Author(s):  
Liyuan Wu ◽  
Lijia Wan ◽  
Min Peng ◽  
Tian Cao ◽  
Qin Wang ◽  
...  
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
P Wave ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Characteristic P ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Line Insertion ◽  
Picc Line

Background Most neonates with persistent left superior vena cava (PLSVC) have no clinical symptoms or hemodynamic changes, and this anomaly is only found during cardiac catheterization, pacemaker implantation, or central venous catheterization. Electrocardiogram (ECG) localization is helpful for the application of the peripherally inserted central catheter (PICC) technique in neonates with PLSVC. Objective To explore the characteristic waveforms of the P wave when a PICC under ECG localization is applied in neonates with PLSVC. Study Design The observation and management strategies for the P wave changes during catheter insertion (CI) of two neonates with PLSVC admitted to our institution between January and July 2020, who underwent PICC line insertion, were summarized. Results The characteristic P wave changes in two children with a PICC line inserted via the PLSVC were observed. When a wide inverted P wave appeared on ECG, the catheter was immediately withdrawn by 0.5 cm, a bidirectional P wave gradually appeared and then disappeared. After that, the catheter was further withdrawn by 0.5 cm. After catheterization, the optimal position of the PICC was confirmed by X-ray photography and bedside B-ultrasound. The PICC line was removed as scheduled after indwelling for 18 and 29 days, respectively, in the two cases, and no PICC-related complications occurred during indwelling. Conclusion The characteristic P wave changes on ECG during CI provide important clinical reference values for the application of the PICC technique under ECG localization in neonates with PLSVC. Key Points

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