Persistent Left Superior Vena Cava Leads to Catheter Malposition during PICC Port Placement

Abstract

Malpositioning of the catheter in the persistent left superior vena cava occurs in 0.3%-0.5% of patients. The catheter was subsequently removed.

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

“…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. In this report, we mainly discuss the intraoperative IC-ECG findings in PLSVC and its related clinical aspects.…”

“…1,2 It is usually asymptomatic and is detected incidentally during procedures like cardiac pacemaker implantation, 3,4 chest imaging, 2,5 and central venous catheterization. [6][7][8][9] In venous catheterization, PLSVC is usually confirmed by postoperative imaging. Given the paramount importance of tip position to venous ports, it is crucial to identify PLSVC intraoperatively.…”

Classification and quantification of double superior vena cava evaluated by computed tomography imaging

“…First, it may complicate the placement of central venous catheters or the implantation of cardiovascular devices because of the technical difficulties involved in passing the catheter through the narrow opening of the coronary sinus into the right heart when using a left superior venous approach. Such cases may lead to injury of the vessel wall, incorrect positioning of the catheter, or more serious complications, such as cardiac arrest (2,4,15,16). The presence of an LSVC may also necessitate the use of a preshaped stylet (pigtail, J-shaped, L-shaped, or U-shaped) or require the formation of a wide loop within the right atrium, depending on the device being implanted (2).…”

Tunnelled haemodialysis catheter insertion into the persistent left superior vena cava

“…PLSVC is usually diagnosed during central vein catheterization, pacemaker placement or cardiac surgery. [9][10][11] However, on a plain P-A film, suggestive radiologic signs include widening of the mediastinum, an enlarged aortic shadow, or paramediastinal prominence below the aortic arch. Dilatation of the coronary sinus seen on echocardiography may also be suggestive.…”