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Liječnički vjesnik, Vol. 142 No. 5-6, 2020.

Original scientific paper

https://doi.org/10.26800/LV-142-5-6-25

Persistent Left Superior Vena Cava Identified after Central Venous Catheter Placement – Case Report

Dagmar Oberhofer ; Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Sveti Duh, Zagreb
Tino Klancir ; Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Sveti Duh, Zagreb
Ana Jadrijević Štefek ; Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Sveti Duh, Zagreb
Ninoslav Rudman ; Zavod za radiologiju, Klinička bolnica Sveti Duh, Zagreb

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Abstract

Persistent left superior vena cava (PLSVC) is the most frequent congenital anomaly of the cardinal systemic venous return. It is usually asymptomatic and discovered incidentally during central venous access procedures via the left internal jugular or subclavian vein. We present a case of an 86-year old female admitted with a head injury and rib fractures on her left side. A central venous catheter (CVC) was inserted into the left internal jugular vein under ultrasound guidance without complication. The post insertion chest X-ray showed the catheter
in the left paravertebral position and malposition of CVC was suspected. Another CVC was placed in the right internal jugular vein with the correct positioning of the CVC in the superior vena cava on chest X-ray. Although central venous pressure on the right and left side was the same, the left central venous pressure waveform was atypical. A thoracic computed tomography with contrast and digital subtraction angiography through the left cubital vein confirmed the diagnosis of a PLSVC draining into the right atrium via the coronary sinus. Ascertaining the pattern of cardiac venous return is essential, as the site of drainage (right or left atrium) determines the possible use of a CVC placed in PLSVC.

Keywords

VENA CAVA, SUPERIOR – abnormalities, diagnostic imaging; CENTRAL VENOUS CATHETERS – adverse effects; VASCULAR MALFORMATIONS – diagnostic imaging; TOMOGRAPHY, X-RAY COMPUTED; IMAGING, TREE-DIMENSIONAL; ANGIOGRAPHY, DIGITAL SUBTRACTION; INCIDENTAL FINDINGS

Hrčak ID:

240261

URI

https://hrcak.srce.hr/240261

Publication date:

29.6.2020.

Article data in other languages: croatian

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