Antecubital Central Venous Catheter Placement Complicated by a Persistent Left Superior Vena Cava

Abstract

A 14-year-old female in whom we encountered a persistent left superior vena cava during placement of a central venous catheter is presented. The patient had a history of coarctation of the aorta, but the left superior vena cava was unknown. Since the incidence of persistent left superior vena cava in patients with congenital heart disease is ten times as great as those without, in this patient population it may be useful to obtain radiographic confirmation of catheter position before use.

Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients

“…Those papers in the literature that have specifically addressed the incidental finding of PLSVC at the time of placement of some sort of central venous access device or some sort of central venous monitoring device [38,42,44-123] have generally been directed towards physicians practicing anesthesia [47,48,52,55,58-60,62,64,65,68-71,73,78,85,88,91,92,94,102,117,120,123], critical care [45,46,49-51,53,56,57,72,77,79,83,106,109,110,114,116,119,122], and nephrology [54,66,74,76,80,87,95,96,100,103,104,107,108,113,118]. Despite the fact that a plethora of papers have been published on various aspects of PLSVC and despite there being multiple case reports describing the incidental finding of PLSVC at the time of central venous device placement, there has been very little in the literature specifically directed toward the potential importance of the incidental finding of PLSVC to surgeons, interventional radiologists, and other physicians who are actively involved in central venous access device placement in cancer patients [61,81,82,84,111].…”