Internal Jugular Vein Valves: Clear and Present Danger

Abstract

AM, et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003;107: 996-1002. 2 Wernovsky G, Wypij D, Jonas RA, et al. Postoperative course and hemodynamic profile after the arterial switch operation in neonates and infants. A comparison of low-flow cardiopulmonary bypass and circulatory arrest.

Internal jugular vein valves complicating central venous catheter placement: a case report

“…In about half of the cases these valves are at the level of the clavicle (3). This makes them harder to visualize with echography and other case reports have been made where the valves were initially missed even though the placement was echo-guided (7,8). A thorough preprocedural assessment of the internal jugular vein, including the most caudal regions, is thus warranted.…”

“…Although jugular vein valves are observed in a large proportion of the population (3,4,6), clinical problems are rarely encountered as the relatively few case reports for a frequently preformed procedure suggest (7,(9)(10)(11)(12)(13). The high prevalence (up to 90%) of incompetent valves ( 14) could be a reason why resistance during cannulation appears to be rarely encountered.…”