Catheterization in a patient with end-stage renal disease through persistent left superior vena cava: a rare case report and literature review

Abstract

Background Persistent left superior vena cava (PLSVC) is a common vena cava malformation, and drains blood into the right atrium via the dilated coronary sinus in most cases. It is usually asymptomatic and detected incidentally during invasive procedures or imaging. Whether the hemodialysis catheters can be placed in PLSVC is still controversial now (Stylianou et al. Hemodial Int 11:42-45, 2007). Case presentation Here we report a rare case of catheterization through PLSVC in an end-stage renal disease (ESRD) male patient whose PLSVC connected with pulmonary vein with insufficient blood flow eventually. Among the other 28 cases included in the literature review, 16 cases were non-tunneled catheter and 12 cases were cuffed, tunneled catheter and most of them could provide adequate blood flow. Conclusion PLSVC is a rare malformation and mostly asymptotic, we believe that PLSVC drains blood into the right atrium with enough inner diameter and blood flow can serve as an alternative site for conventional dialysis access. However, the feasibility of hemodialysis catheterization through it and measures to avoid serious complications are still needed to be discussed.

Isolated Persistent Left Superior Vena Cava Revealed by an Associated Asthma

“…PLSVC is an uncommon vascular anomaly but is considered the most common congenital anomaly of the thoracic venous system [ 2 ]. The incidence is about 0.1 to 0.5% of the total population [ 2 ].…”

“…The detection of PLSVC is important when the left subclavian vein is used for catheterization procedures like Swan-Ganz catheterization and usage in renal dialysis [ 2 , 4 ], in chemotherapy, or in cardiac stimulator placement [ 7 , 8 ]. These investigations can be complicated by left subclavian vein thrombosis, cardiac arrhythmia, perforation of the coronary sinus, cardiac tamponade, cardiogenic shock, or even death [ 4 ].…”

Intraoperative identification of persistent left superior vena cava with intracavitary electrocardiogram during venous port insertion: A report of eight cases

“…PLSVC is a well-recognized congenital anomaly of chest venous system. There are numerous reports on central catheters inserted into this vein, including central inserted central catheters (CICCs), 8,12 dialysis catheters, [13][14][15] peripheral inserted central catheters (PICCs), 16,17 and ports. 6,18 The anatomical aspect of this anomaly is described in detail elsewhere 1,19 and is not the main topic of this report.…”

Persistent Left Superior Vena Cava – Accidental Finding

“…The presence of PLSVC is important when the left subclavian vein is used for different catheterization procedures: Swan-Ganz catheterization, usage in renal dialysis (32), in oncological treatment (33) or in cardiac stimulator placement (34)(35)(36). In all of the abovementioned situations severe complications may occur: left subclavian vein thrombosis, cardiac arrhythmias, perforation of the coronary sinus, cardiac tamponade, cardiogenic shock or even death.…”