Bedside confirmation of a persistent left superior vena cava based on aberrantly positioned central venous catheter on chest radiograph

Ghadiali, Natascha Fherzinah; Teo, L.W.; Sheah, Kenneth

doi:10.1093/bja/aei272

Cited by 37 publications

(32 citation statements)

References 7 publications

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“…The PLSCV, found in approximately 0.3-0.5% of the population, is usually detected on echocardiography, CT, postmortem, or invasive cardiac procedures, such as transvenous CIED implantation [12,13,15,22]. The population analysed in our centre exhibited a 0.2% prevalence of this venous anomaly.…”

Section: Discussionmentioning

confidence: 89%

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Imaging topography and morphometry of persistent left superior caval vein and its variations, detected on cardiac implantable electronic device implantation

et al. 2017

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Section: Discussionmentioning

confidence: 89%

“…by symptomatic congenital heart defects may remain long undetected and be discovered incidentally only during cardiological, anaesthetic, or diagnostic procedures [3,12,13,18,22,23]. One of such venous variations is the presence of persistent left superior caval vein (PLSCV) (Fig.…”

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confidence: 99%

Imaging topography and morphometry of persistent left superior caval vein and its variations, detected on cardiac implantable electronic device implantation

et al. 2017

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“…Cases involving the left superior intercostal, azygos, and left accessory hemiazygos veins have been described [8][9][10]. Persistent left superior vena cava, which is found in 0.3% to 0.5% of healthy individuals, can sometimes be the entry point for a malpositioned CVC when an approach through the LIJV is used, as presented by Ghadiali and colleagues [11]. Azygous cannulation has been associated with intermittent back pain [12].…”

Section: Discussionmentioning

confidence: 99%

Are we underestimating the frequency of malpositioned central venous catheters inserted via the left internal jugular vein? A case report and short review of literature

et al. 2010

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AbstractCentral venous cannulation is a widely used procedure in clinical medicine. Central venous catheters are inserted most often via the internal jugular and subclavian veins. One of the complications is malpositioning of the catheter, and some insertion sites carry a higher risk for that occurrence. We report a case of a malpositioned central venous catheter inserted via the left internal jugular vein in a patient with a ruptured diaphragm. Our objectives were to review the venous anatomy of the chest and the literature reporting malpositioned central venous catheters and to discuss the approach through the left internal jugular vein. Left internal jugular cannulation could carry a higher rate of malposition than reported, and anatomy gives a possible, simple answer. Contrast enhancement, although central venous catheters are radiopaque, is helpful when an approach through the left internal jugular vein is used and difficulties are encountered during insertion.

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“…The most frequent variant (82%) of the normal anatomy is the simultaneous presence of both right and left cava veins (double superior vena cava, type III) and so this anomaly is often missed as central line catheters are more commonly inserted on the right side [20,21]. Persistence of Left SVC with, absent right superior vena cava (type II) occurs in only 0.09-0.13% of patients with congenital heart disease [11].…”

Section: Commentmentioning

confidence: 99%

The Role of 3-Dimensional Ultrasound for the Diagnosis of LPSVC and A Review of the Literature

Ellithyb¹

2014

Gynecol Obstet(sunnyvale)

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Objective: The purpose of this article is to review the published literature and determine the rolethat3-dimensional Ultrasonography (3DUS) play in the diagnosis of LPSVC. Methods:The volume data sets were acquired with transverse sweeps through the fetal chest. Volumes were stored in the ultrasound machine's hard drive and subsequently analyzed offline.Results: PLSVC was unequivocally diagnosed and the diagnosis confirmed by postnatal US.Conclusion: 3D ultrasonography especially power Doppler imaging made it possible to unequivocally confirm the diagnosis of the LPSVC and demonstrate LPSVC entering the dilated coronary sinus. The images obtained made it easy to explain this anomaly to the patient. This case of isolated LPSVC in a 30 -week fetus demonstrates the added value of 3D ultrasonography and especially 3D power colour in fetal echocardiography. Case PresentationA 39-year-old woman, gravida 2 para 1, presented at 30 weeks' gestation for detailed targeted organ scanning with fetal echocardiography, after having received contradictory opinions concerning a suspected atrioventricular canal defect during previous ultrasound examinations. Karyotype, which had been tested because of advanced maternal age, was normal. Targeted organ scanning for exclusion of fetal anomalies was performed, including complete fetal echocardiography 2 and 3 D US and coulor Doppler and 3 D Power Doppler power imaging (Figures 1-3).In the present case, the initial diagnosis of LPSVC was made on observation of a dilated coronary sinus and an extraneous vessel identified to the left of the ductal arch in the three-vessels and trachea (3VT) view of the fetal heart ( Figures 1E ,F and 3D).We performed ultrasound examinations using a GE Voluson 730 pro. (Voluson 730, GE Healthcare, Milwaukee, WI, USA) using a 3-5-MHz mechanical volume transabdominal transducer). The volumes were stored and subsequently analyzed offline.Meticulous inspection of the fetal anatomy did not reveal any associated cardiac or extra cardiac anomalies and fetal growth was on the 50th centile. A male neonate was spontaneously delivered at38 weeks of gestation with a birth weight of 3150 g with Apgar scores of 8, 9 and 10 at 1,5 and 10 min, respectively. Postnatal adaptation was uneventful. Postnatal echocardiography confirmed the prenatal diagnosis.3D power Doppler imaging made it possible to unequivocally confirm the diagnosis of the LPSVC and demonstrate LPSVC entering the dilated coronary sinus (Figures 1 and 3). The images obtained made it easy to explain this anomaly to the patient. This case of isolated LPSVC in a 30-week fetus demonstrates the added value of power colour Doppler 3D in fetal echocardiography.It appears that 3Dpower Doppler imaging applications will make a significant contribution to our understanding of the developing fetal heart in both normal and anomalous cases, to interdisciplinary management team consultation, to parental counselling, and to professional training CommentPersistent left superior vena cava is a rare but is the most...

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Bedside confirmation of a persistent left superior vena cava based on aberrantly positioned central venous catheter on chest radiograph

Cited by 37 publications

References 7 publications

Imaging topography and morphometry of persistent left superior caval vein and its variations, detected on cardiac implantable electronic device implantation

Imaging topography and morphometry of persistent left superior caval vein and its variations, detected on cardiac implantable electronic device implantation

Are we underestimating the frequency of malpositioned central venous catheters inserted via the left internal jugular vein? A case report and short review of literature

The Role of 3-Dimensional Ultrasound for the Diagnosis of LPSVC and A Review of the Literature

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